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Head Neck. 2019 Apr;41(4):E59-E61. doi: 10.1002/hed.25572. Epub 2018 Dec 27.

Human papilloma virus-associated squamous cell carcinoma of the larynx in an 18-year-old woman.

Author information

1
Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland.
2
Admed Pathologie, Neuchâtel, Switzerland.
3
Institute of Microbiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.

Abstract

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.

KEYWORDS:

human papilloma virus; larynx; squamous cell carcinoma; transmission; vaccination

PMID:
30589154
DOI:
10.1002/hed.25572

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