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Head and Neck
Diagnosis
Primary Sites, Perineural Tumor and Nodes
Oropharyngeal Carcinoma
HPV-Mediated (p16+) Oropharyngeal Carcinoma
HPV-Mediated (p16+) Oropharyngeal Carcinoma
Philip R. Chapman, MD
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8

OVERVIEW

  • General Comments

    • Classification

      PATHOLOGY

      • Routes of Spread

        • General Features

          • Gross Pathology & Surgical Features

            • Microscopic Features

              IMAGING FINDINGS

              • Detection

                • Staging

                  CLINICAL ISSUES

                  • Presentation

                    • Cancer Natural History & Prognosis

                      • Treatment Options

                        REPORTING CHECKLIST

                        • T Staging

                          • N Staging

                            • M Staging

                              Selected References

                              1. Lu Y et al: Global burden of oropharyngeal cancer attributable to human papillomavirus by anatomical subsite and geographic region. Cancer Epidemiol. 78:102140, 2022
                              2. Benchetrit L et al: Prognostic significance of extranodal extension in HPV-mediated oropharyngeal carcinoma: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 164(4):720-32, 2021
                              3. Day AT et al: Extracapsular extension, pathologic node status, and adjuvant treatment in primary surgery patients with human papillomavirus-mediated oropharyngeal cancer: national hospital-based retrospective cohort analysis. Head Neck. 43(11):3345-63, 2021
                              4. Dong H et al: Current status of human papillomavirus-related head and neck cancer: from viral genome to patient care. Virol Sin. 36(6):1284-302, 2021
                              5. Sabiq F et al: Novel imaging classification system of nodal disease in human papillomavirus-mediated oropharyngeal squamous cell carcinoma prognostic of patient outcomes. Head Neck. 43(6):1854-63, 2021
                              6. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                              7. Tumban E: A current update on human papillomavirus-associated head and neck cancers. Viruses. 11(10), 2019
                              8. Buckley L et al: HPV-related oropharyngeal carcinoma: a review of clinical and pathologic features with emphasis on updates in clinical and pathologic staging. Adv Anat Pathol. 25(3):180-8, 2018
                              9. Leijenaar RT et al: Development and validation of a radiomic signature to predict HPV (p16) status from standard CT imaging: a multicenter study. Br J Radiol. 91(1086):20170498, 2018
                              10. Liu C et al: How does smoking change the clinicopathological characteristics of human papillomavirus-positive oropharyngeal squamous cell carcinoma? One medical center experience. Clin Med Insights Ear Nose Throat. 11:1179550618792248, 2018
                              11. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                              12. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                              13. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                              14. Faraji F et al: Emerging insights into recurrent and metastatic human papillomavirus-related oropharyngeal squamous cell carcinoma. Laryngoscope Investig Otolaryngol. 2(1):10-8, 2017
                              15. Fossum CC et al: Characterization of the oropharynx: anatomy, histology, immunology, squamous cell carcinoma and surgical resection. Histopathology. 70(7):1021-9, 2017
                              16. Goel R et al: Clinical practice in PET/CT for the management of head and neck squamous cell cancer. AJR Am J Roentgenol. 209(2):289-303, 2017
                              17. Huang YH et al: Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy: relationship with human papillomavirus status and failure patterns. PLoS One. 12(7):e0180779, 2017
                              18. Lydiatt WM et al: Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 67(2):122-37, 2017
                              19. Rath TJ et al: Solid lymph nodes as an imaging biomarker for risk stratification in human papillomavirus-related oropharyngeal squamous cell carcinoma. AJNR Am J Neuroradiol. 38(7):1405-10, 2017
                              20. Stenmark MH et al: Influence of human papillomavirus on the clinical presentation of oropharyngeal carcinoma in the United States. Laryngoscope. 127(10):2270-8, 2017
                              21. Theodoraki MN et al: Synchronous bilateral tonsil carcinoma: case presentation and review of the literature. Infect Agent Cancer. 12:38, 2017
                              22. Chan MW et al: Radiologic differences between human papillomavirus-related and human papillomavirus-unrelated oropharyngeal carcinoma on diffusion-weighted imaging. ORL J Otorhinolaryngol Relat Spec. 78(6):344-52, 2016
                              23. Wassef HR et al: PET/CT in head-neck malignancies: the implications for personalized clinical practice. PET Clin. 11(3):219-32, 2016
                              24. Bishop JA et al: HPV-related squamous cell carcinoma of the head and neck: an update on testing in routine pathology practice. Semin Diagn Pathol. 32(5):344-51, 2015
                              25. Gillison ML et al: Epidemiology of human papillomavirus-positive head and neck squamous cell carcinoma. J Clin Oncol. 33(29):3235-42, 2015
                              26. Garden AS et al: Management of the lymph node-positive neck in the patient with human papillomavirus-associated oropharyngeal cancer. Cancer. 120(19):3082-8, 2014
                              27. Tahari AK et al: FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors. Clin Nucl Med. 39(3):225-31, 2014
                              28. Cantrell SC et al: Differences in imaging characteristics of HPV-positive and HPV-negative oropharyngeal cancers: a blinded matched-pair analysis. AJNR Am J Neuroradiol. 34(10):2005-9, 2013
                              29. Kaka AS et al: Highly aggressive human papillomavirus-related oropharyngeal cancer: clinical, radiologic, and pathologic characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol. 116(3):327-35, 2013
                              30. Ang KK et al: Human papillomavirus as a marker of the natural history and response to therapy of head and neck squamous cell carcinoma. Semin Radiat Oncol. 22(2):128-42, 2012
                              31. Chernock RD: Morphologic features of conventional squamous cell carcinoma of the oropharynx: 'keratinizing' and 'nonkeratinizing' histologic types as the basis for a consistent classification system. Head Neck Pathol. 6 Suppl 1:S41-7, 2012
                              32. Snow AN et al: Human papillomavirus detection in head and neck squamous cell carcinomas. Adv Anat Pathol. 17(6):394-403, 2010
                              33. Ahuja AT et al: Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 8:48-56, 2008
                              34. Capron F et al: [Primary broncho-pulmonary cancers. Pathological anatomy.] Rev Prat. 43(14):1879-82, 1993
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              OVERVIEW

                              • General Comments

                                • Classification

                                  PATHOLOGY

                                  • Routes of Spread

                                    • General Features

                                      • Gross Pathology & Surgical Features

                                        • Microscopic Features

                                          IMAGING FINDINGS

                                          • Detection

                                            • Staging

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Cancer Natural History & Prognosis

                                                  • Treatment Options

                                                    REPORTING CHECKLIST

                                                    • T Staging

                                                      • N Staging

                                                        • M Staging

                                                          Selected References

                                                          1. Lu Y et al: Global burden of oropharyngeal cancer attributable to human papillomavirus by anatomical subsite and geographic region. Cancer Epidemiol. 78:102140, 2022
                                                          2. Benchetrit L et al: Prognostic significance of extranodal extension in HPV-mediated oropharyngeal carcinoma: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 164(4):720-32, 2021
                                                          3. Day AT et al: Extracapsular extension, pathologic node status, and adjuvant treatment in primary surgery patients with human papillomavirus-mediated oropharyngeal cancer: national hospital-based retrospective cohort analysis. Head Neck. 43(11):3345-63, 2021
                                                          4. Dong H et al: Current status of human papillomavirus-related head and neck cancer: from viral genome to patient care. Virol Sin. 36(6):1284-302, 2021
                                                          5. Sabiq F et al: Novel imaging classification system of nodal disease in human papillomavirus-mediated oropharyngeal squamous cell carcinoma prognostic of patient outcomes. Head Neck. 43(6):1854-63, 2021
                                                          6. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                                                          7. Tumban E: A current update on human papillomavirus-associated head and neck cancers. Viruses. 11(10), 2019
                                                          8. Buckley L et al: HPV-related oropharyngeal carcinoma: a review of clinical and pathologic features with emphasis on updates in clinical and pathologic staging. Adv Anat Pathol. 25(3):180-8, 2018
                                                          9. Leijenaar RT et al: Development and validation of a radiomic signature to predict HPV (p16) status from standard CT imaging: a multicenter study. Br J Radiol. 91(1086):20170498, 2018
                                                          10. Liu C et al: How does smoking change the clinicopathological characteristics of human papillomavirus-positive oropharyngeal squamous cell carcinoma? One medical center experience. Clin Med Insights Ear Nose Throat. 11:1179550618792248, 2018
                                                          11. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                                                          12. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                                                          13. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                                                          14. Faraji F et al: Emerging insights into recurrent and metastatic human papillomavirus-related oropharyngeal squamous cell carcinoma. Laryngoscope Investig Otolaryngol. 2(1):10-8, 2017
                                                          15. Fossum CC et al: Characterization of the oropharynx: anatomy, histology, immunology, squamous cell carcinoma and surgical resection. Histopathology. 70(7):1021-9, 2017
                                                          16. Goel R et al: Clinical practice in PET/CT for the management of head and neck squamous cell cancer. AJR Am J Roentgenol. 209(2):289-303, 2017
                                                          17. Huang YH et al: Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy: relationship with human papillomavirus status and failure patterns. PLoS One. 12(7):e0180779, 2017
                                                          18. Lydiatt WM et al: Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 67(2):122-37, 2017
                                                          19. Rath TJ et al: Solid lymph nodes as an imaging biomarker for risk stratification in human papillomavirus-related oropharyngeal squamous cell carcinoma. AJNR Am J Neuroradiol. 38(7):1405-10, 2017
                                                          20. Stenmark MH et al: Influence of human papillomavirus on the clinical presentation of oropharyngeal carcinoma in the United States. Laryngoscope. 127(10):2270-8, 2017
                                                          21. Theodoraki MN et al: Synchronous bilateral tonsil carcinoma: case presentation and review of the literature. Infect Agent Cancer. 12:38, 2017
                                                          22. Chan MW et al: Radiologic differences between human papillomavirus-related and human papillomavirus-unrelated oropharyngeal carcinoma on diffusion-weighted imaging. ORL J Otorhinolaryngol Relat Spec. 78(6):344-52, 2016
                                                          23. Wassef HR et al: PET/CT in head-neck malignancies: the implications for personalized clinical practice. PET Clin. 11(3):219-32, 2016
                                                          24. Bishop JA et al: HPV-related squamous cell carcinoma of the head and neck: an update on testing in routine pathology practice. Semin Diagn Pathol. 32(5):344-51, 2015
                                                          25. Gillison ML et al: Epidemiology of human papillomavirus-positive head and neck squamous cell carcinoma. J Clin Oncol. 33(29):3235-42, 2015
                                                          26. Garden AS et al: Management of the lymph node-positive neck in the patient with human papillomavirus-associated oropharyngeal cancer. Cancer. 120(19):3082-8, 2014
                                                          27. Tahari AK et al: FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors. Clin Nucl Med. 39(3):225-31, 2014
                                                          28. Cantrell SC et al: Differences in imaging characteristics of HPV-positive and HPV-negative oropharyngeal cancers: a blinded matched-pair analysis. AJNR Am J Neuroradiol. 34(10):2005-9, 2013
                                                          29. Kaka AS et al: Highly aggressive human papillomavirus-related oropharyngeal cancer: clinical, radiologic, and pathologic characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol. 116(3):327-35, 2013
                                                          30. Ang KK et al: Human papillomavirus as a marker of the natural history and response to therapy of head and neck squamous cell carcinoma. Semin Radiat Oncol. 22(2):128-42, 2012
                                                          31. Chernock RD: Morphologic features of conventional squamous cell carcinoma of the oropharynx: 'keratinizing' and 'nonkeratinizing' histologic types as the basis for a consistent classification system. Head Neck Pathol. 6 Suppl 1:S41-7, 2012
                                                          32. Snow AN et al: Human papillomavirus detection in head and neck squamous cell carcinomas. Adv Anat Pathol. 17(6):394-403, 2010
                                                          33. Ahuja AT et al: Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 8:48-56, 2008
                                                          34. Capron F et al: [Primary broncho-pulmonary cancers. Pathological anatomy.] Rev Prat. 43(14):1879-82, 1993