While it is important to know the common clinical presentation, a high index of suspicion is necessary when patients have presentations concerning for a neck mass. If a lesion is identified, suspected but not visualized, or the patient endorses troublesome symptoms, a low threshold for referral to an otolaryngologist for further workup is necessary. Workup includes imaging and visualization of primary sites via endoscopy, although OPSCC can only be diagnosed via biopsy of a primary or metastatic lesion. Following the biopsy, tumor samples will undergo either polymerase chain reaction amplification of HPV DNA or in situ hybridization to determine if it is HPV-positive or HPV-negative.
J Am Board Fam Med. 2021;34(4):832-837. © 2021 American Board of Family Medicine