High risk human papilloma virus induced oropharyngeal squamous cell carcinoma following immune suppressive treatment of multiple sclerosis: Challenges in screening and early diagnosis

Abstract

High-risk human papillomavirus (HR HPV) is associated with oropharyngeal squamous cell carcinoma (OPSCC), which is rising. Although the association and mechanism of viral carcinogenesis are well established, the exact risk and time of cancer development in a patient are unclear. We present a 64-year-old Caucasian male with a history of the spinal form of multiple sclerosis manifesting as stable quadriplegia whose development of progressive dysphagia was associated with HR HPV OPSCC. Despite optimal treatment, cancer progressed, suggesting refractoriness to treatment. We discuss the clinical relevance of anti-cancer immunity and the adverse effects of immune-suppressive treatment of autoimmune diseases such as multiple sclerosis on treatment outcomes of virally induced cancer such as OPSCC. Improving awareness of the association between immune suppression and HPV-associated cancer development is emphasized, and the beneficial role of HPV vaccination cancer prevention is discussed.

Keywords

• Human papillomavirus
• Head and neck cancer
• Oropharyngeal cancer
• Squamous cell carcinoma
• Prevention
• Vaccination