case_images: PMC11320681_01
case_images: Axial sections of R.M.'s neck computed tomography (CT) (a) and positron emission tomography (PET) scans (b) reveal a 3 cm mass with fludeoxyglucose (FDG) uptake in the right tonsillar fossa extending into the parapharyngeal space. Axial sections of K.M.'s neck CT (c) and PET scans (d) demonstrate a 3.4 x 3.2 cm enhancing mass in the right oropharynx with strong FDG uptake that extends up to the inferior nasopharynx and soft palate.
case_images: 10.1177_2050313X241271762-fig1.jpg
case_images: PMC11320681_02_10.1177_2050313X241271762-fig1.jpg
case_images: fig1-2050313X241271762
case_images: CT of the neck uncovered a 3.4 x 3.2 cm mass of the right tonsil and base of the tongue that extended into the inferior nasopharynx and soft palate, alongside a contralateral level 2 lymph node and an ipsilateral level 3 lymphadenopathy measuring 2.5 x 5 cm (Figure 1(c)). Right neck node FNA and a following PET scan (Figure 1(d)) confirmed metastatic involvement of the OPSCC, placing him at clinical stage III (T4 N2 M0) HPV-positive OPSCC.
case_images: PMC11320681_02
case_images: Axial sections of R.M.'s neck computed tomography (CT) (a) and positron emission tomography (PET) scans (b) reveal a 3 cm mass with fludeoxyglucose (FDG) uptake in the right tonsillar fossa extending into the parapharyngeal space. Axial sections of K.M.'s neck CT (c) and PET scans (d) demonstrate a 3.4 x 3.2 cm enhancing mass in the right oropharynx with strong FDG uptake that extends up to the inferior nasopharynx and soft palate.
case_images: 10.1177_2050313X241271762-fig1.jpg
case_images: PMC11320681_02_10.1177_2050313X241271762-fig1.jpg
case_images: fig1-2050313X241271762
case_images: CT of the neck uncovered a 3.4 x 3.2 cm mass of the right tonsil and base of the tongue that extended into the inferior nasopharynx and soft palate, alongside a contralateral level 2 lymph node and an ipsilateral level 3 lymphadenopathy measuring 2.5 x 5 cm (Figure 1(c)). Right neck node FNA and a following PET scan (Figure 1(d)) confirmed metastatic involvement of the OPSCC, placing him at clinical stage III (T4 N2 M0) HPV-positive OPSCC.
case_images: (a) H&E stain of K.M.'s right tonsil. The section reveals non-keratinizing squamous proliferation, large hyperchromatic nuclei, abundant mitoses, and basal cell morphology. This is consistent with well to moderately differentiated squamous cell carcinomas (200x). (b) Immunohistochemical stain with 3,3'-diaminobenzidine chromogen of K.M.'s tumor exhibiting block-like staining in the basal cell layer, positive for p16INK4a (200x). (R.M.'s pathology slides were unavailable for use.).
case_images: 10.1177_2050313X241271762-fig2.jpg
case_images: PMC11320681_02_10.1177_2050313X241271762-fig2.jpg
case_images: fig2-2050313X241271762
case_images: Pathology of the tonsil was consistent with squamous cell carcinoma (Figure 2(a)), with IHC staining being positive for p16 (Figure 2(b)), and the HPV16 genotype.