Introduction
Globally, the overwhelming majority of nasopharyngeal carcinomas (NPC)
occur within endemic or migrant south East Asian populations driven by
exposure to the Epstein-Barr virus (EBV). However, human papillomavirus
(HPV) associated NPC has also been described, mostly in Caucasian
populations. Co-infections with both EBV and HPV has been rarely
reported and similar to oropharyngeal cancer (OPC), p16 shows high
sensitivity and specificity for HPV associated NPC (1).
There are few reports of synchronous or metachronous p16+/HPV+ cancers
where the nasopharynx is primarily involved (excluding those with
extension from the oropharynx). Caley et al. reported 11 cases of
synchronous and metachronous p16+ head and neck squamous cell carcinoma
(SCC), which included two cases involving metachronous nasopharynx and
OPC (2). McGovern el al described an interesting report of synchronous
HPV-associated SCC involving the bilateral tonsils and nasopharynx
treated with radical intent radiotherapy and concurrent chemotherapy(3).
We report a case of a patient presenting with synchronous p16+ SCC
involving the nasopharynx and BOT treated at our institution