Invasive Squamous Cell Carcinoma of the Oral Mucosa Associated with HPV Type 53


A 77-year old Korean man presented with a fungating mass on the right aspect of his lower lip, which had been growing for 5 months. He was a non-smoker, with no history of alcohol consumption, betel quid use or excessive sun exposure. His past medical history was significant for prostate cancer and transurethral resection without additional ad­juvant chemotherapy six months before. At that time, he was also found to have latent syphilis and treated with penicillin.

fig.1 verrucous

Fig. 1. Verrucous-surfaced, white, fungating mass with an irregular margin on the oral mucosa.

The skin lesion was an irregu­lar, round (1.5 cm by 1.5 cm), whitish fungating mass extending from the right angle of the mouth to the right one-sixth of the lower lip. It was relatively well-demarcated and had a verrucous surface. The mass was excised and diagnosed histopathologically as a verrucous carcinoma. Surgical margins were clear and CT of the head and neck showed no evidence of metastasis. After ten months, the patient came back with recurrence of the mass detected by the patient 4 months prior. This time, it was 1.5 cm by 2.0 cm with a more irregular shape than previously. The margin was infiltrating the lip and buccal mucosa resulting in indistinct demarcation (Fig. 1). An incisional biopsy revealed an invasive squamous cell carcinoma (Fig. 2). He was transferred to the department of plastic surgery for wide exci­sion. HPV DNA was detected in the biopsy speci­men by PCR using MY09/MY11 primers (MY09: 5′-CGT CCM ARR GGA WAC TGA TC-3′, MY 11: 5′-GCM CAG GGW CAT AAY AAT GG-3′). We determined the HPV type as HPV-53 by direct cycle sequencing (Fig. 3). cialis 10 mg

fig.2 invasive

Fig. 2. Invasive squamous cell carcinoma infiltrating into the deep dermis (H & E, X 100).

fig.3 detection

Fig. 3. Detection of HPV DNA in the biopsy specimen by PCR. The band of 450 bp was detected and iden­tified as HPV 53 by direct cycle sequencing.