title: Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal : Case report of a child.
abstract: BACKGROUND
  There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2‑year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary.
  
  
  METHODS
  A 2‑year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival.
  
  
  CONCLUSIONS
  This is the first case of advanced, HPV-related HNSCC in a 2‑year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor.
authors.affiliation: Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland. mirek@snietura.net.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Snietura
authors.affiliation: Department of Oncology and Hematology, University Children's Hospital of Cracow, Cracow, Poland.
authors.forename: Liliana
authors.initials: L
authors.lastname: Chelmecka-Wiktorczyk
authors.affiliation: Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Pakulo
authors.affiliation: Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kopec
authors.affiliation: Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Piglowski
authors.affiliation: Pathology Department, University Children's Hospital of Cracow, Cracow, Poland.
authors.forename: Grazyna
authors.initials: G
authors.lastname: Drabik
authors.affiliation: NZOZ Prosmed, Cracow, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Kosowski
authors.affiliation: Department of Radiology, University Children's Hospital of Cracow, Cracow, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Wyrobek
authors.affiliation: Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Stanek-Widera
authors.affiliation: Department of Oncology and Hematology, University Children's Hospital of Cracow, Cracow, Poland.|Clinic of Oncology and Hematology, Polish-American Pediatric Institute, Jagiellonian University in Cracow, Cracow, Poland.
authors.forename: Walentyna
authors.initials: W
authors.lastname: Balwierz
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000628:therapy* / Q000821:virology*; D059248:Chemoradiotherapy; D002675:Child, Preschool; D004424:Ear Canal; D004428:Ear Neoplasms / Q000628:therapy* / Q000821:virology*; D005260:Female; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000628:therapy / Q000821:virology; D016896:Treatment Outcome
keywords: Chemoradiotherapy; Ear canal; Human papillomavirus; Pediatrics; Vertical infection transmission