Yanagita Yasutaka, Shikino Kiyoshi
General Medicine, Chiba University Hospital, Chiba, JPN.
Community-Oriented Medical Education, Chiba University Graduate School of Medicine, Chiba, JPN.
Cureus. 2025 Jul 17;17(7):e88206. doi: 10.7759/cureus.88206. eCollection 2025 Jul.
A middle-aged woman presented with progressive pharyngeal symptoms and an enlarging neck mass, eventually diagnosed as human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC). Due to impending airway obstruction, an emergency tracheostomy was performed. Histopathological examination confirmed squamous cell carcinoma, leading to a final diagnosis of non-HPV-associated OPSCC, a rarer and more aggressive subtype. Despite receiving palliative radiotherapy for symptom control, the disease progressed aggressively, and the patient was ultimately transitioned to best supportive care. OPSCC arises from the mucosal epithelium of the oropharynx. Early symptoms such as persistent throat discomfort, dysphagia, and cervical lymphadenopathy are relatively characteristic of oropharyngeal tumors. Tumor progression can cause critical airway obstruction depending on the lesion's size and location. In this report, we present a case of OPSCC that required emergency airway management due to the risk of airway obstruction. This case underscores the importance of early diagnosis and airway management in patients with progressive pharyngeal symptoms and high-risk features.
一名中年女性出现进行性咽部症状和颈部肿块增大，最终被诊断为人乳头瘤病毒（HPV）阴性口咽鳞状细胞癌（OPSCC）。由于即将出现气道阻塞，遂进行了紧急气管切开术。组织病理学检查证实为鳞状细胞癌，最终诊断为非HPV相关的OPSCC，这是一种较为罕见且侵袭性更强的亚型。尽管接受了姑息性放疗以控制症状，但疾病仍进展迅速，患者最终转为最佳支持治疗。OPSCC起源于口咽的黏膜上皮。诸如持续咽喉不适、吞咽困难和颈部淋巴结病等早期症状是口咽肿瘤相对典型的表现。肿瘤进展可根据病变的大小和位置导致严重的气道阻塞。在本报告中，我们呈现了一例因气道阻塞风险而需要紧急气道管理的OPSCC病例。该病例强调了对有进行性咽部症状和高危特征的患者进行早期诊断和气道管理的重要性。
