Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma [Neurosurgery Wiki]

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=====Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma=====
Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) represents an emerging disease that differs from HPV-negative OPSCC in natural history and prognosis. Contrast-enhanced PET/CT is essential to accurately stage the primary site when there are smaller tumors; neck nodal metastases, which tend to have a more cystic component; and distant metastases that manifest in unusual sites (disseminating phenotype) such as bones and other solid organs, including brain. Metastases tend to appear later in the disease course during follow-up for HPV-positive OPSCC than for HPV-negative OPSCC. Because HPV-positive OPSCC patients have a better clinical outcome, there is a need for treatment deintensification to spare the patient from treatment-related toxicities. 18F-FDG PET/CT would play a role in monitoring patients with deintensified treatments to ensure that no adverse outcome is introduced. The better prognosis and outcome of HPV-positive OPSCC patients would warrant imaging follow-up that is less intense but continues longer because of the manifestation of distant metastases later in the disease course and at unusual sites. All these clinical paradigms facilitate a definite role for PET/CT imaging in the management of HPV-positive OPSCC ((Subramaniam RM, Alluri KC, Tahari AK, Aygun N, Quon H. PET/CT Imaging and
Human Papilloma Virus-Positive Oropharyngeal Squamous Cell Cancer: Evolving
Clinical Imaging Paradigm. J Nucl Med. 2014 Jan 9. [Epub ahead of print] PubMed
PMID: 24408893.)).