HPV-Associated Head and Neck Second Primary Tumors-A Case Series

Background: There is limited understanding of head and neck second primary tumors (SPTs) in HPV-associated squamous cell carcinoma (SCC). Analogous to the concept of field cancerization of the upper airway known to contribute to the development of smoking-related head and neck SPTs, this case series reports four cases of HPV-associated SPTs.

Methods: We reviewed the charts of four patients diagnosed with HPV-associated oropharyngeal SCC who subsequently developed HPV-associated SPTs. Clinical data was collected, including demographics, tumor characteristics, time elapsed between the two diagnoses, and treatment type.

Results: The average age of the patients was 68 years. All of the patients were non-smokers, and none reported heavy alcohol use. All patients had the first cancer in the oropharynx. The time between the first and second diagnoses ranged from 3 and 12 years.

Conclusion: HPV has not been previously identified as a risk factor for head and neck SPTs. Given the long period between the first and second cancers and the lack of other risk factors for head and neck cancer, our case series demonstrates HPV-associated head and neck SPTs.