Snietura Miroslaw, Chelmecka-Wiktorczyk Liliana, Pakulo Slawomir, Kopec Agnieszka, Piglowski Wojciech, Drabik Grazyna, Kosowski Bogdan, Wyrobek Lukasz, Stanek-Widera Agata, Balwierz Walentyna
Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
Department of Oncology and Hematology, University Children's Hospital of Cracow, Cracow, Poland.
Strahlenther Onkol. 2017 Feb;193(2):156-161. doi: 10.1007/s00066-016-1047-z. Epub 2016 Sep 19.
There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2‑year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary.
A 2‑year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival.
This is the first case of advanced, HPV-related HNSCC in a 2‑year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor.
有大量证据表明，高危型人乳头瘤病毒（HPV）在成人头颈部鳞状细胞癌（HNSCC）的一个亚组中起致病作用。HPV阳性肿瘤即使在对治疗的反应方面也表现不同，因此是一个独特的亚组。头颈部区域的HPV阳性和阴性肿瘤通常发生在成人中，儿童病例罕见；因此，当一名2岁儿童被诊断出外耳道患有这种癌症时，有必要对肿瘤进行深入评估。
一名2岁女孩的母亲HPV呈阳性，在怀孕期间被诊断出患有宫颈癌。孩子通过剖宫产出生，母亲在分娩7个月后死于癌症。在诊断出外耳道局部浸润性HPV阳性鳞状细胞癌后，对该儿童进行了手术、化疗和放疗。自开始治疗以来，实现了完全缓解，持续长达325周，实现了超过6年的无病生存。
这是首例2岁儿童发生的晚期、HPV相关的HNSCC病例，肿瘤位于外耳道，经非根治性手术、化疗和放疗后显著康复。该儿童目前已无病生存6年。该病例支持以下观察结果：尽管患者年龄小且肿瘤处于临床晚期，但HPV相关的HNSCC肿瘤似乎对治疗反应良好。
