title: Oropharyngeal carcinoma arising after methotrexate and etanercept therapy for rheumatoid arthritis.
abstract: Etanercept is an anti-tumor necrosis factor α receptor agent used to treat inflammatory conditions. Previous reports described rapid development of skin squamous cell carcinoma (SCC) after etanercept use. This report describes a novel case of oropharyngeal SCC associated with the use of etanercept. A 45-year-old man with rheumatoid arthritis developed oropharyngeal pain within 2 months after the start of etanercept therapy and was diagnosed with tonsillar carcinoma. This patient had other exposures that increase the risk of oropharyngeal cancer, such as tobacco and alcohol use. However, owing to the timing of onset of his initial symptoms, etanercept should be considered as a possible factor in the etiology or progression of his tumor, especially in the context of reported skin SCC after etanercept therapy in patients at risk for SCC. Clinicians should be alert to signs of malignancy in patients on etanercept, particularly those at high risk for skin or head and neck cancers.
authors: Department of Orofacial Sciences, University of California San Francisco, CA, USA; Private Practice in Oral Medicine, Mountain View, CA, USA. Electronic address: nitacwu@hotmail.com.
authors: Nita
authors: N
authors: Chainani-Wu
authors: School of Dentistry, University of California San Francisco, CA, USA.
authors: Crystal
authors: C
authors: Chang
authors: Department of Medicine, Rheumatology, University of California San Francisco, CA, USA.
authors: A J
authors: AJ
authors: Gross
authors: Departments of Radiation Oncology and Otolaryngology - Head and Neck Surgery, University of California San Francisco, CA, USA.
authors: S S
authors: SS
authors: Yom
authors: Department of Orofacial Sciences, University of California San Francisco, CA, USA.
authors: Sol
authors: S
authors: Silverman
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced* / Q000473:pathology; D003937:Diagnosis, Differential; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000139:chemically induced* / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate