title: Three synchronous HPV-associated squamous cell carcinomas of Waldeyer's ring: case report and comparison with Slaughter's model of field cancerization.
abstract: BACKGROUND
  Patients with squamous cell carcinoma (SCC) of the oropharynx have an 8% to 20% risk of a synchronous or metachronous second malignancy. The rate of synchronous lesions in human papillomavirus (HPV)-positive oropharyngeal cancers is unknown.
  
  
  METHODS
  We report the case of a 46-year-old man with 3 simultaneous primary malignancies of Waldeyer's ring: HPV-positive SCC of both tonsils and the nasopharynx, with bilateral neck metastases.
  
  
  RESULTS
  The patient received induction chemotherapy followed by definitive radiotherapy and remains free of disease at 18 months.
  
  
  CONCLUSIONS
  Comparison with the Slaughter model of field cancerization suggests that HPV-positive SCC of the head and neck may have a distinct mechanism for the development of multifocal disease. Therefore, the emerging population of young patients with head and neck SCC with HPV-positive cancers presents a new opportunity for understanding the molecular origins of synchronous tumors.
authors: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors: Susan L
authors: SL
authors: McGovern
authors: Michelle D
authors: MD
authors: Williams
authors: Randal S
authors: RS
authors: Weber
authors: Anita
authors: A
authors: Sabichi
authors: Mark S
authors: MS
authors: Chambers
authors: Jack W
authors: JW
authors: Martin
authors: K S Clifford
authors: KS
authors: Chao
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000628:therapy / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000628:therapy / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology* / Q000628:therapy