The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
Squamous cell carcinoma metastatic to neck from an unknown primary: The potential impact of modern pathologic evaluation on perceived incidence of human papillomavirus–positive oropharyngeal carcinoma prior to 1970†
Article first published online: 17 JAN 2012
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 4, pages 793–796, April 2012
How to Cite
Chenevert, J., Seethala, R. R., Barnes, E. L. and Chiosea, S. I. (2012), Squamous cell carcinoma metastatic to neck from an unknown primary: The potential impact of modern pathologic evaluation on perceived incidence of human papillomavirus–positive oropharyngeal carcinoma prior to 1970. The Laryngoscope, 122: 793–796. doi: 10.1002/lary.21899
- Issue published online: 20 MAR 2012
- Article first published online: 17 JAN 2012
- Manuscript Accepted: 6 APR 2011
- Manuscript Revised: 1 APR 2011
- Manuscript Received: 15 DEC 2010
- Human papillomavirus;
- unknown primary;
- Level of Evidence: 2.
From the 1950s through the 1960s, an unknown number of oropharyngeal squamous cell carcinomas (SCCs) presented with metastases to cervical lymph nodes from an unknown primary (SCCUP) and were not recognized as oropharyngeal in origin. At present, pathologic evaluation of SCCUP for human papillomavirus (HPV) improves discovery of occult oropharyngeal SCC and may partially explain increased incidence of HPV-positive oropharyngeal SCC.
Retrospective cohort study.
A retrospective study of 13 cases of SCCUP diagnosed from 1956 to 1969 was performed. The probability of these cases of metastatic SCC to originate from the oropharynx was assessed by characterizing their morphology (keratinizing vs. nonkeratinizing) and HPV status by in situ hybridization and p16 immunostaining.
Two cases of nonkeratinizing SCC positive for HPV by in situ hybridization and p16 immunohistochemistry were identified. These cases were most likely of oropharyngeal origin.
These two cases can be added to the other 15 cases of HPV-positive primary oropharyngeal SCC identified in our department from 1956 to 1969. When determining the incidence of HPV-positive oropharyngeal SCC before the 1970s, a correction factor of about +13% (2/15) accounting for modern pathologic workup of SCCUP during the last couple of decades may be appropriate. Laryngoscope, 2012