[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-340027-105":59,"doc-detail-340027-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","paraneoplastic-pemphigus-associated-with-nonhuman-papillomavirusrelated-tonsillar-squamous-cell-carcinoma-a-case-report","Paraneoplastic pemphigus associated with nonhuman papillomavirus–related tonsillar squamous cell carcinoma - A case report","","Paraneoplastic pemphigus (PNP) is a rare, life-threatening autoimmune bullous disease linked to occult malignancy. Among about 500 reported PNP cases, only one has involved tonsillar cancer, specifically human papillomavirus (HPV)-positive squamous carcinoma, while PNP in non-HPV-related tonsillar cancer has not been previously reported. This case report describes a 58-year-old man with recurrent oral ulcers, neck swelling, and hoarseness, whose diagnosis confirmed tonsillar squamous cell carcinoma not associated with HPV and histologic evidence of PNP.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/paraneoplastic-pemphigus-associated-with-nonhuman-papillomavirusrelated-tonsillar-squamous-cell-carcinoma-a-case-report/340027/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/paraneoplastic-pemphigus-associated-with-nonhuman-papillomavirusrelated-tonsillar-squamous-cell-carcinoma-a-case-report/340027.png","ImageObject",300,407,{"name":92,"@type":93},"Miles","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is paraneoplastic pemphigus (PNP) and why is it clinically important?","Question",{"text":112,"@type":113},"PNP is a rare autoimmune bullous disease caused by an underlying occult malignancy and can be life-threatening, with a high reported mortality rate.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the diagnosis established in this case?",{"text":117,"@type":113},"Imaging and pathology confirmed right tonsillar squamous cell carcinoma not associated with HPV, and histological plus immunohistochemical findings indicated PNP.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment approach was used and what were the outcomes during follow-up?",{"text":121,"@type":113},"The patient underwent tumor resection and ipsilateral neck dissection, received topical steroids and antifungals for oral lesions, and completed adjuvant concurrent chemoradiotherapy with cisplatin, with 3, 6, and 9 month follow-up showing no recurrence of cancer or PNP.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},340027,1790138634,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","®  \n Clinical Case Report   \nParaneoplastic pemphigus associated with nonhuman papillomavirus–related tonsillarsquamous cell carcinoma  \nA case report  \nShih-Chun Lu, MDa , Hung-Lun Chu, PhD, MDa ,c , Hann-Ziong Yueh, MDa , Che-Hsuan Lin, MD, PhDa ,b , Yang Chou, MDa ,*  \n\n| Abstract\u003Cbr>Background: Paraneoplastic pemphigus (PNP) is a rare, life-threatening autoimmune bullous disease. Among the ≈500 reported cases of PNP, only 1 case has been associated with tonsillar cancer, specifically, human papillomavirus (HPV)–positivesquamous carcinoma. However, the occurrence of PNP in non-HPV–related tonsillar cancer is exceptionally rare and has not been reported to date.\u003Cbr>Methods: We present a 58-year-old male with a history of smoking, who experienced recurrent oral ulcers, right neck swelling, and hoarseness for 5 months. Diagnosis of right tonsillar squamous cell carcinoma (cT1N3bM0) was confirmed through computed tomography/magnetic resonance imaging and pathology, not associated with HPV. Histological and immunohistochemical findings indicated PNP.\u003Cbr>Results: The patient underwent primary tumor resection and ipsilateral neck dissection. Topical steroids and antifungal agents were administered to manage oral lesions and prevent secondary infections. Adjuvant concurrent chemoradiotherapy with cisplatin proceeded smoothly. Postconcurrent chemoradiotherapy follow-up at 3, 6, and 9 months, utilizing computed tomography/ magnetic resonance imaging and nasopharyngoscopy, revealed no signs of recurrent cancer or PNP.\u003Cbr>Conclusion: Early indicators, such as oral mucosal ulcers and skin blisters, prompt consideration of underlying oral cancer in PNP. Comprehensive examination is crucial for diagnosing PNP and identifying concurrent internal neoplasms. Effective management includes occult malignancy treatment, postoperative steroid therapy, and infection prevention.\u003Cbr>Abbreviations: CCRT = concurrent chemoradiotherapy, DIF = direct immunofluorescence, HPV = human papillomavirus, LAP = lymphadenopathy, NHL = non-Hodgkin lymphoma, PNP = paraneoplastic pemphigus. |\n| --- |\n| Keywords: human papillomavirus, oral ulcers, oropharyngeal cancer, paraneoplastic pemphigus, tonsillar cancer. |\n\n1. Introduction  \nParaneoplastic pemphigus (PNP) is a rare autoimmune bullous disease with occult cancer, such as non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia.[1] PNP constitutes ≈3% to 5% of pemphigus cases and is characterized by a mortality rate of up to 90%.[2] While autoimmune antibodies against plakin proteins are reported in PNP, a complete understanding  \nof its pathogenesis remains unclear, posing challenges for early diagnosis. Tonsillar cancer is a well-known oral cancer, highly associated with risk factors, such as smoking, alcohol, betel nut, and human papillomavirus (HPV) infection.[3] The association of PNP and tonsillar cancer is extremely rare. To the best of our knowledge, only 1 case report has documented the cooccurrence of tonsillar cancer and PNP, where the cancer was HPVp16 positive.[4] To the best of our knowledge, PNP associated  \nS-CL and H-LC contributed to this article equally.  \nThis study was approved by the ethics committee of Taipei Medical University Hospital, Taiwan.  \nThe authors confirm that the parents of the patient have given their written informed consent to publish the case report, as well as pictures and tables. Written informed consent was obtained from the patient for publication of this case report and any accompanying images.  \nThe authors have no conflicts of interest to disclose.  \nAll data generated or analyzed during this study are included in this published article and its supplementary information files.  \nThis study was conducted in accordance with the ethics committee of Taipei Medical University Hospital, Taiwan. The information of the patient was anonymously presented in the figures and article.  \na Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan, b Dep","cbCaiae8CZyAPfAu","https://ap.wps.com/l/cbCaiae8CZyAPfAu","pdf",693870,"English","# Abstract\n# Introduction\n## Background on PNP and tonsillar cancer\n# Case presentation\n## Clinical presentation and diagnostic findings\n# Treatment and follow-up\n## Surgery and adjuvant therapy\n# Conclusion\n## Diagnostic considerations and management","[{\"question\":\"What is paraneoplastic pemphigus (PNP) and why is it clinically important?\",\"answer\":\"PNP is a rare autoimmune bullous disease caused by an underlying occult malignancy and can be life-threatening, with a high reported mortality rate.\"},{\"question\":\"How was the diagnosis established in this case?\",\"answer\":\"Imaging and pathology confirmed right tonsillar squamous cell carcinoma not associated with HPV, and histological plus immunohistochemical findings indicated PNP.\"},{\"question\":\"What treatment approach was used and what were the outcomes during follow-up?\",\"answer\":\"The patient underwent tumor resection and ipsilateral neck dissection, received topical steroids and antifungals for oral lesions, and completed adjuvant concurrent chemoradiotherapy with cisplatin, with 3, 6, and 9 month follow-up showing no recurrence of cancer or PNP.\"}]","Paraneoplastic pemphigus associated with nonhuman papillomavirus–related tonsillar squamous cell carcinoma - A case report | PDF",1790033818]