Location
Moultrie, GA
Start Date
9-5-2023 1:00 PM
End Date
9-5-2023 4:00 PM
Description
INTRODUCTION
Oropharyngeal Cancer (OC), primarily caused by squamous cell carcinoma, has risen recently. OC is often categorized into HPV-associated carcinoma or non-HPV-associated carcinoma. Environmental factors such as tobacco and alcohol use significantly increase risk of OC and are associated with non-HPV-associated OC. While research has investigated common gene mutations associated with an increased risk of OC, there are only a few cases highlighting genes that lead to its cutaneous spread, which represents less than 10% of cases.
OBJECTIVE
This study's primary objective was to determine what genetic/environmental factors may have contributed to the development of multiple OC metastatic tumors with significant and otherwise rare cutaneous spread.
METHODS
This was a cadaveric study that involved taking tissue samples from various sites on the skin, lungs, trachea, and submandibular lymph nodes. Tissue samples were processed at the pathology lab at Colquitt Regional Medical Center. The histology slides were analyzed on routine hematoxylin and eosin stains. Special stains (Ki-67, p16, and p53) were used to characterize the tumor further.
RESULTS
Histopathological samples revealed a poorly differentiated keratinizing squamous cell carcinoma of the oropharynx. Tumor sections showed sheets and nests of enlarged hyperchromatic nuclei, polymorphism, and numerous necrotic centers. Examined skin samples indicated the spread of the tumors through muscular layers and the subcutaneous tissue leading to skin infiltration and ulceration. Lymph nodes showed tumor metastasis and anthracosis in the form of black pigment deposition in the lymph nodes. Ki-67 staining was highly positive that reflected the proliferative index of the tumor. Approximately 90-95% of tumor cells were positive for p16. Tumor samples were negative for P53 markers.
CONCLUSION
In this case study, analysis of cadaveric samples of tissue biopsies revealed genetic factors that are the likely major contributors to disease manifestation and/or metastasis. Histopathological reports revealed multiple reasons for malignancy—the genetic presence of a mutation in tumor suppressor genes p16. P53 was also found to be absent in the results. These findings indicate HPV-associated oropharyngeal squamous cell carcinoma. Additionally, we discovered a rare type of metastatic OC that not only spread to common sites of metastasis (lungs and liver) but also into the epithelium of the skin. Environmental factors in the form of smoking were also probably involved since we demonstrated anthracosis.
Embargo Period
7-9-2024
Included in
Widespread cutaneous metastasis of oropharyngeal cancer
Moultrie, GA
INTRODUCTION
Oropharyngeal Cancer (OC), primarily caused by squamous cell carcinoma, has risen recently. OC is often categorized into HPV-associated carcinoma or non-HPV-associated carcinoma. Environmental factors such as tobacco and alcohol use significantly increase risk of OC and are associated with non-HPV-associated OC. While research has investigated common gene mutations associated with an increased risk of OC, there are only a few cases highlighting genes that lead to its cutaneous spread, which represents less than 10% of cases.
OBJECTIVE
This study's primary objective was to determine what genetic/environmental factors may have contributed to the development of multiple OC metastatic tumors with significant and otherwise rare cutaneous spread.
METHODS
This was a cadaveric study that involved taking tissue samples from various sites on the skin, lungs, trachea, and submandibular lymph nodes. Tissue samples were processed at the pathology lab at Colquitt Regional Medical Center. The histology slides were analyzed on routine hematoxylin and eosin stains. Special stains (Ki-67, p16, and p53) were used to characterize the tumor further.
RESULTS
Histopathological samples revealed a poorly differentiated keratinizing squamous cell carcinoma of the oropharynx. Tumor sections showed sheets and nests of enlarged hyperchromatic nuclei, polymorphism, and numerous necrotic centers. Examined skin samples indicated the spread of the tumors through muscular layers and the subcutaneous tissue leading to skin infiltration and ulceration. Lymph nodes showed tumor metastasis and anthracosis in the form of black pigment deposition in the lymph nodes. Ki-67 staining was highly positive that reflected the proliferative index of the tumor. Approximately 90-95% of tumor cells were positive for p16. Tumor samples were negative for P53 markers.
CONCLUSION
In this case study, analysis of cadaveric samples of tissue biopsies revealed genetic factors that are the likely major contributors to disease manifestation and/or metastasis. Histopathological reports revealed multiple reasons for malignancy—the genetic presence of a mutation in tumor suppressor genes p16. P53 was also found to be absent in the results. These findings indicate HPV-associated oropharyngeal squamous cell carcinoma. Additionally, we discovered a rare type of metastatic OC that not only spread to common sites of metastasis (lungs and liver) but also into the epithelium of the skin. Environmental factors in the form of smoking were also probably involved since we demonstrated anthracosis.
Comments
PCOM South Georgia Research Day 2023 Award for Best Visual Presentation