Keywords:
Cancer, Staging, Education, CT, Oncology, Head and neck
Authors:
G. B. Verrone1, F. Mungai2, M. Pietragalla2, L. Bonasera2, V. Miele2; 1Firenze/IT, 2Florence/IT
DOI:
10.26044/ecr2019/C-1540
Aims and objectives
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 tumours staging systems based on the presence or absence of high-risk HPV [5].
It has been observed that these two types of tumours,
due to their histo-pathological diversity,
may have different morphological aspects to imaging [6].
The aim of this work is to illustrate the qualitative morphological aspects found on CT imaging of both the primary tumour (T) and the lymphadenopathy (N) of the OPSCC and to highlight the correlation with HPV status (Fig. 2).
In particular,
we evaluated:
- the growth pattern (exophytic and/or infiltrative)
- the extranodal extension (ENE)
- the appearance of lymphadenopathies (cystic vs.
necrotic/solid)