Abstract:
HPV-related oropharyngeal carcinoma (OPC) is a clinically
and molecularly distinct form of squamous cell carcinoma
(SCC) which has recently shown a dramatic increase in
global incidence. The aetiology, clinical presentation and
overall prognosis differ from conventional tobacco and alcohol
related SCC of the oral cavity. OPC is seen in a subset
of younger predominantly male patients. Acquisition of highrisk
HPV subtypes is related to oral sex practices with multiple
partners. OPC originates deep within tonsillar crypts
which hinders early clinical detection. Patients present with
advanced disease and frequent cervical lymph node metastases.
Despite its aggressive nature, the overall prognosis
remains excellent compared with conventional oral SCC.
The increased incidence of OPC is of clinical significance to
the general dentist and should always be considered in the
clinical differential diagnosis in a young, otherwise healthy,
patient with persistent cervical lymph node enlargement.
Older patients with a history of tobacco usage and alcohol
consumption may also present with conventional SCC of
the oropharynx. Potentially malignant disease may precede
tumour development at this site in such cases. Clinical examination
of the oropharynx should therefore be performed
as part of routine dental consultation.
