The Human Papilloma Virus (HPV) is currently responsible for an increasing number of head and neck cancers, regardless of exposure to smoking and drinking [1,2]. The oropharynx is the most affected site because the virus replicates in the lymphoepithelial tissue of the palatine and lingual tonsil [3]. HPV-positive(HPV+) squamous cell carcinomas of the oropharynx (OPSCC) have a better prognosis than their HPV-negative (HPV-) counterparts and respond better to chemo and radiotherapy [4]. In fact, the latest edition of the AJCC has separated the squamous cell...

We retrospectively evaluated patients diagnosed with OPSCC(palatine tonsils and tongue base). 81 patients were recruited regardless of tumour staging; of these, 12 were excluded because they had not undergone contrast-enhanced staging CT in our hospital and 7 were excluded due to important artefacts from metal implants or dental amalgam (Fig. 3). 62 patients were finally included, 44 men and 18 women, the age ranged from 42 to 81 years. HPV status was established by evaluating overexpression of p16 protein by immunohistochemistry. CT scans were evaluated...

33 patients were HPV-positive and 29 HPV-negative. Eight patients had no identifiable primary lesion: 5 were HPV+ and 3 HPV- and were excluded from the assessment of the primary lesion. Nine patients had no lymph node metastases: 4 were HPV+ and 5 were HPV- and were excluded from the morphological evaluation of lymphadenopathy. Exophytic growth pattern of primary tumour was found in 17/28 (61%)HPV+OPSCC and in 9/26 (35%) inHPV-OPSCC without statistically correlation, although it was more frequent in theHPV+OPSCC (Fig. 9). The tendency to invade...

Our case series shows a statistically significant correlation between: - the cystic changes of the lymphadenopathy and the presence of HPV+ status - thedeep muscle invasion of the primary lesion and the HPV status according to the literature [6-8] (Fig. 13). The invasion of deep muscles and the more typically infiltrative aspect of HPV- OPSCC is correlated to a greater aggressiveness of these tumours given by numerous gene mutations induced by exposure to smoke and alcohol, as opposed to HPV+ tumours that often arise in...

Dr. Giovanni Battista Verrone Department of Radiology, Careggi University Hospital, Florence, Italy. [email protected]

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