A late cutaneous HPV 16 positive metastases of the skin in a patient with HPV 16 positive Oropharynx carcinoma. A rarity

We report on a male patient, born in 1959 without relevant comorbidities, who was diagnosed wiht a HPV 16 positive tonsil carcinoma on the right (pT2 pN1 M0) in March 2016.

After panendoscopy, therapy was carried out with laser tumor resection, neck dissection level II to IV on the right, and adjuvant RCT.

The tumor follow-up examinations were without findings until May 2021. At this point HPV 16 positive squamous cell carcinoma of the tip of the nose (pT3 pN0 M0) was diagnosed.

Molecular pathological examinations could detect an infection with HPV type 16 (high-risk). Histologically, both tumors are HPV 16 positive, invasive, keratinizing squamous cell carcinomas with little and moderate differentiation. After consulting our pathologists, this was seen as metastasis (M1).

The succesfull surgical therapy by means of partial nasal ablation was conducted.

Discussion Cutaneous metastases are rare and are observed in approx. 0.5% of all cancer patients. Metastases of head and neck tumors represent only a fraction of these and are mostly also located in the head and neck area.

Initially, a cutaneous metastasis seems therfore unlikely, however, given the molecular pathological and morphological examinations are most probably causal.

Summary The significantly more favorable survival rates of HPV positive patients increase the likelihood of developing late metastases, even in unusual locations. This is should be considered when planning the follow-up visits.

Conflict of Interest

The author declares that there is no conflict of interest.

Publication History

Article published online:
24 May 2022