台耳醫誌

Papillary squamous cell carcinoma (PSCC) of the head and neck is an uncommon malignancy characterized by a high propensity for local recurrence and the development of second primary tumors. We present the case of a 65-year-old Taiwanese man who initially presented with a papillomatous lesion of the left epiglottis, which progressed to PSCC. Following surgical resection and adjuvant radiotherapy, metachronous tumors developed in the trachea and nasopharynx during long-term follow-up. Histopathological analysis of the three lesions demonstrated papillary architecture with dysplastic epithelial lining and stromal invasion. Immunohistochemistry revealed diffuse p63 and p53 positivity, with negative staining for p16 and Epstein–Barr virusencoded RNA (EBER), consistent with a high-grade, HPV-independent PSCC. This case underscores the necessity of long-term surveillance in patients with PSCC due to the risk of recurrence and development of metachronous malignancies across the head and neck region. (J Taiwan Otolaryngol Head Neck Surg 2026; 60:155-159)