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Head and Neck Pathology
Published in: Head and Neck Pathology 4/2022

30-06-2022 | Human Papillomavirus | Case Reports

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

Authors: S. A. Rasmussen, J. S. Lewis Jr, L. Mirabello, S. Bass, M. Yeager, M. J. Corsten, M. J. Bullock

Published in: Head and Neck Pathology | Issue 4/2022

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Abstract

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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Metadata
Title
A Case of HPV-Associated Oropharyngeal Squamous Cell Carcinoma with Block-Like, Partial Loss of p16 Expression
Authors
S. A. Rasmussen
J. S. Lewis Jr
L. Mirabello
S. Bass
M. Yeager
M. J. Corsten
M. J. Bullock
Publication date
30-06-2022
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 4/2022
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-022-01463-4

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