Solitary dural metastasis at presentation in a patient with untreated human papillomavirus-associated squamous cell carcinoma of the oropharynx

Head Neck. 2014 Oct;36(10):E103-5. doi: 10.1002/hed.23589. Epub 2014 Mar 20.


Background: Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (SCC) is associated with high cure rates and distant metastases are rare.

Methods and results: We report a case of a 61-year-old man presenting with acute left-sided weakness. An enhancing dural mass was noted and resected. Histology revealed p16-positive SCC. Further workup revealed a p16-positive right tonsillar primary with ipsilateral nodal disease and was classified as T2N2bM1. The patient underwent whole brain irradiation and definitive chemoradiation with curative intent. Complete clinical response was achieved and the patient continues to be disease-free 6 months posttreatment.

Conclusion: HPV-associated oligometastatic oropharyngeal SCC is a rare entity that may have a unique natural history and behavior. Given the excellent treatment response and prognosis of HPV-positive disease in general, these patients may be appropriate for definitive treatment approaches.

Keywords: dural metastasis; human papillomavirus; tonsillar cancer.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / virology
  • Cyclin-Dependent Kinase Inhibitor p16
  • Dura Mater*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / virology*
  • Humans
  • Immunohistochemistry
  • Male
  • Meningeal Neoplasms / secondary*
  • Meningeal Neoplasms / virology*
  • Middle Aged
  • Neoplasm Proteins / metabolism
  • Radiotherapy Dosage
  • Squamous Cell Carcinoma of Head and Neck
  • Tonsillar Neoplasms / pathology*
  • Tonsillar Neoplasms / virology*


  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16
  • Neoplasm Proteins