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Human papilloma virus‐associated squamous cell carcinoma of the larynx in an 18‐year‐old woman
Author(s) -
Hotz MichelAndré,
Christen Brigitte,
Sahli Roland,
Arnold Andreas Michael
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25572
Subject(s) - gardasil , medicine , larynx , human papilloma virus , dysplasia , histopathology , hpv infection , lesion , dermatology , papilloma , basal cell , cancer , pathology , cervical cancer , surgery
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.