Human papilloma virus‐associated squamous cell carcinoma of the larynx in an 18‐year‐old woman

Abstract

Background

Human papilloma virus (HPV)‐associated malignancies are considered to be sexually transmitted diseases.

Methods

We report a HPV‐positive larynx cancer in an 18‐year‐old female clarinet player, despite vaccination with the quadrivalent HPV‐6‐11‐16‐18‐vaccine Gardasil (Merck Sharp & Dohme Corp., West Point, Pennsylvania). The patient showed no evidence of genito‐oral infection but showed some evidence for oral‐oral HPV transmission through the sharing of saliva‐infested clarinet mouthpieces. A right vocal cord lesion of benign appearance was removed via free margin resection.

Results

Histopathology revealed a microinvasive squamous cell carcinoma inside a zone of high‐grade dysplasia that was positive for HPV‐45. No tumor recurrence was observed during a 4‐year follow‐up evaluation.

Conclusion

Benign lesion appearance and quadrivalent HPV vaccine status do not exclude HPV‐associated malignancies. In our patient, the Gardasil vaccine did not provide crossover protection against HPV 45 infection. HPV‐associated disease may not necessarily be transmitted via sexual practice patterns alone.

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