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A Case of HPV-Associated Oropharyngeal Squamous Cell Carcinoma with Block-Like, Partial Loss of p16 Expression

Background Oropharyngeal squamous cell carcinoma is frequently associated with high-risk HPV infection, which confers a good prognosis. Immunohistochemistry for p16 is used as a surrogate for HPV status, but discrepant results are occasionally seen. Here, we report a case with a unique pattern of pa...

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Published in:Head & neck pathology (Totowa, N.J.) N.J.), 2022-12, Vol.16 (4), p.1251-1256
Main Authors: Rasmussen, S. A., Lewis, J. S., Mirabello, L., Bass, S., Yeager, M., Corsten, M. J., Bullock, M. J.
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container_title Head & neck pathology (Totowa, N.J.)
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creator Rasmussen, S. A.
Lewis, J. S.
Mirabello, L.
Bass, S.
Yeager, M.
Corsten, M. J.
Bullock, M. J.
description Background Oropharyngeal squamous cell carcinoma is frequently associated with high-risk HPV infection, which confers a good prognosis. Immunohistochemistry for p16 is used as a surrogate for HPV status, but discrepant results are occasionally seen. Here, we report a case with a unique pattern of partial loss of p16. Methods A 63 year old male presented with a base of tongue nonkeratinizing squamous cell carcinoma and a large metastatic neck mass. The primary lesion and multiple regions of the metastatic mass were assessed with p16 immunohistochemistry, RNA in situ hybridization for high-risk HPV, and HPV16 genome sequencing. Results The primary lesion was p16 negative, and the metastatic neck mass had large, confluent regions that were either strongly p16 positive or entirely p16 negative. All of these regions were positive for high-risk HPV with identical HPV16 genomes. Conclusion This unusual case illustrates a potential diagnostic pitfall, and it raises important questions regarding molecular mechanisms and prognostic implications of p16 staining in oropharyngeal squamous cell carcinoma.
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A. ; Lewis, J. S. ; Mirabello, L. ; Bass, S. ; Yeager, M. ; Corsten, M. J. ; Bullock, M. J.</creator><creatorcontrib>Rasmussen, S. A. ; Lewis, J. S. ; Mirabello, L. ; Bass, S. ; Yeager, M. ; Corsten, M. J. ; Bullock, M. J.</creatorcontrib><description>Background Oropharyngeal squamous cell carcinoma is frequently associated with high-risk HPV infection, which confers a good prognosis. Immunohistochemistry for p16 is used as a surrogate for HPV status, but discrepant results are occasionally seen. Here, we report a case with a unique pattern of partial loss of p16. Methods A 63 year old male presented with a base of tongue nonkeratinizing squamous cell carcinoma and a large metastatic neck mass. The primary lesion and multiple regions of the metastatic mass were assessed with p16 immunohistochemistry, RNA in situ hybridization for high-risk HPV, and HPV16 genome sequencing. Results The primary lesion was p16 negative, and the metastatic neck mass had large, confluent regions that were either strongly p16 positive or entirely p16 negative. All of these regions were positive for high-risk HPV with identical HPV16 genomes. 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Methods A 63 year old male presented with a base of tongue nonkeratinizing squamous cell carcinoma and a large metastatic neck mass. The primary lesion and multiple regions of the metastatic mass were assessed with p16 immunohistochemistry, RNA in situ hybridization for high-risk HPV, and HPV16 genome sequencing. Results The primary lesion was p16 negative, and the metastatic neck mass had large, confluent regions that were either strongly p16 positive or entirely p16 negative. All of these regions were positive for high-risk HPV with identical HPV16 genomes. 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subjects Case Reports
Dentistry
Head and Neck Neoplasms
Humans
Medicine
Medicine & Public Health
Middle Aged
Oral and Maxillofacial Surgery
Otorhinolaryngology
Papillomavirus Infections - complications
Pathology
Squamous Cell Carcinoma of Head and Neck
title A Case of HPV-Associated Oropharyngeal Squamous Cell Carcinoma with Block-Like, Partial Loss of p16 Expression
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