A Case of Metachronous Human Papilloma Virus-Associated Squamous Cell Carcinomas in Head and Neck

Synchronous or metachronous head and neck cancer is known to occur in up to 20% of patients, negatively affecting long-term prognosis. We experienced a case of metachronous head and neck cancers in a Human papillomavirus (HPV)-positive patient without a history of smoking, initially presenting with as a cancer of unknown primary (CUP), and then with a contralateral tonsil cancer with metastatic lymphadenopathy five years later. This report highlights the clini cal usefulness of HPV typing to determine the optimal extent of surgery and the follow-up strategy in CUP.