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HPV and EBV Infections in Neck Metastases from Occult Primary Squamous Cell Carcinoma: Another Virus-Related Neoplastic Disease in the Head and Neck Region

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Approximately 1–9 % of all head and neck squamous cell carcinomas are neck metastases from clinically undetectable primary tumors. Human papillomavirus (HPV) and Epstein–Barr virus (EBV) are proven carcinogenic factors that are associated with oropharyngeal squamous cell carcinoma and nasopharyngeal carcinoma, respectively. In the present study, we evaluated the prevalence of these viruses in neck metastases from unknown primary squamous cell carcinoma.

Methods

We evaluated fresh samples from a consecutive series of 22 neck dissections for metastases from unknown primary squamous cell carcinoma obtained between 2010 and 2012 at a single institution. The samples were tested for the presence of HPV E6 and E7 mRNA and EBV DNA.

Results

Oncogenic viral infections were detected in 12 cases (54 % total; 2 HPV18, 5 HPV16, 2 EBV infection, and 3 EBV/HPV16 coinfections). The most frequent primarily involved neck level in our series was IIA (70 %), which had the highest prevalence of viral infection (66 %). We did not find any other significant correlations between virus detection and clinicopathologic parameters or prognosis.

Discussion

Neck metastasis from unknown primary squamous cell carcinoma could be another virus-related malignancy in the head and neck region, along with nasopharyngeal and oropharyngeal carcinoma. An evaluation of the impact of viral infection on patient prognosis and sensitivities to different treatment modalities could modify our prognostic assessments and treatment planning. Furthermore, virus detection would have a decisive impact on diagnostic/decisional algorithms, especially if detection methods are implemented on cytologic samples (e.g., thin prep).

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Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy

    Francesco Bussu MD, PhD, Roberto Gallus MD, Manlio Pandolfini MD, Giovanni Almadori MD, Jacopo Galli MD & Gaetano Paludetti MD

  2. Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy

    Michela Sali PhD , Rosaria Santangelo MD, Giovanni Delogu PhD & Maurizio Sanguinetti MD

  3. Institute of Histopathology, Università Cattolica del Sacro Cuore, Rome, Italy

    Gianluigi Petrone MD & Guido Rindi MD

  4. Institute of Radiotherapy, Università Cattolica del Sacro Cuore, Rome, Italy

    Rosa Autorino MD, Francesco Miccichè MD & Vincenzo Valentini MD

  5. Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France

    Massimo Tommasino PhD

Authors
  1. Francesco Bussu MD, PhD
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  2. Michela Sali PhD
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  3. Roberto Gallus MD
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  9. Giovanni Delogu PhD
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  12. Maurizio Sanguinetti MD
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  16. Gaetano Paludetti MD
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Corresponding author

Correspondence to Roberto Gallus MD.

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Bussu, F., Sali, M., Gallus, R. et al. HPV and EBV Infections in Neck Metastases from Occult Primary Squamous Cell Carcinoma: Another Virus-Related Neoplastic Disease in the Head and Neck Region. Ann Surg Oncol 22 (Suppl 3), 979–984 (2015). https://doi.org/10.1245/s10434-015-4808-5

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  • DOI: https://doi.org/10.1245/s10434-015-4808-5

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