Head & neck · 2018
Human papilloma virus-associated squamous cell carcinoma of the larynx in an 18-year-old woman.
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Hotz Michel-André, Christen Brigitte, Sahli Roland, Arnold Andreas Michael
Аннотация
BACKGROUND: Human papilloma virus (HPV)-associated malignancies are considered to be sexually transmitted diseases.
METHODS: We report a HPV-positive larynx cancer in an 18-year-old female clarinet player, despite vaccination with the quadrivalent HPV-6-11-16-18-vaccine Gardasil (Merck Sharp & Dohme Corp., West Point, Pennsylvania). The patient showed no evidence of genito-oral infection but showed some evidence for oral-oral HPV transmission through the sharing of saliva-infested clarinet mouthpieces. A right vocal cord lesion of benign appearance was removed via free margin resection.
RESULTS: Histopathology revealed a microinvasive squamous cell carcinoma inside a zone of high-grade dysplasia that was positive for HPV-45. No tumor recurrence was observed during a 4-year follow-up evaluation.
CONCLUSION: Benign lesion appearance and quadrivalent HPV vaccine status do not exclude HPV-associated malignancies. In our patient, the Gardasil vaccine did not provide crossover protection against HPV 45 infection. HPV-associated disease may not necessarily be transmitted via sexual practice patterns alone.
METHODS: We report a HPV-positive larynx cancer in an 18-year-old female clarinet player, despite vaccination with the quadrivalent HPV-6-11-16-18-vaccine Gardasil (Merck Sharp & Dohme Corp., West Point, Pennsylvania). The patient showed no evidence of genito-oral infection but showed some evidence for oral-oral HPV transmission through the sharing of saliva-infested clarinet mouthpieces. A right vocal cord lesion of benign appearance was removed via free margin resection.
RESULTS: Histopathology revealed a microinvasive squamous cell carcinoma inside a zone of high-grade dysplasia that was positive for HPV-45. No tumor recurrence was observed during a 4-year follow-up evaluation.
CONCLUSION: Benign lesion appearance and quadrivalent HPV vaccine status do not exclude HPV-associated malignancies. In our patient, the Gardasil vaccine did not provide crossover protection against HPV 45 infection. HPV-associated disease may not necessarily be transmitted via sexual practice patterns alone.
Предметные рубрики MeSH
AdolescentBiopsy, NeedleCarcinoma, Squamous CellFemaleFollow-Up StudiesHuman Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18HumansImmunohistochemistryLaryngeal NeoplasmsLaryngectomyLaryngoscopyNeoplasm InvasivenessNeoplasm StagingPapillomaviridaePapillomavirus InfectionsTreatment OutcomeVaccination