{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:39:47Z","timestamp":1792517987007,"version":"4.5.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The incidence of human papilloma virus (HPV)-mediated head and neck (H\/N) cancers has risen dramatically. While most HPV-associated H\/N cancers are oropharyngeal squamous cell carcinoma (OPSCC), sinonasal squamous cell carcinoma (SNSCC) is the second most common. Recent studies highlight an increasing incidence of HPV-positive SNSCC. Circulating tumor HPV DNA (ctDNA) is a noninvasive tool that has become increasingly utilized to detect high-risk HPV genotypes in the setting of OPSCC, with recent studies reporting high sensitivity and specificity in both pretreatment detection and posttreatment surveillance in OPSCC. Only one study exists reporting its use for SNSCC and nasopharyngeal carcinoma, which was successful in pretreatment detection and identification of recurrence posttreatment.<\/jats:p><jats:p>We report two cases demonstrating the utility of ctDNA in HPV-mediated sinonasal malignancies. Case 1: 60-year-old male who presented with a large nasal cavity cancer. Pretreatment ctDNA testing yielded a positive tumor tissue modified viral (TTMV)-HPV DNA Score of 67, reflective of the normalized tumor tissue modified viral-HPV DNA fragments\/mL of plasma, and pathology confirmed HPV+ SNSCC. Posttreatment surveillance with HPV ctDNA and endoscopy has shown no evidence of disease. Case 2 involves a 64-year-old male with HPV+ neuroendocrine carcinoma who developed recurrence. ctDNA testing, previously negative following initial treatment, scored 35 at recurrence, prompting salvage surgery and adjuvant chemoradiation.<\/jats:p><jats:p>These cases, along with prior studies, underscore the potential of ctDNA as a diagnostic and surveillance tool for sinonasal malignancies. Further multi-institutional prospective trials with larger cohorts are needed to validate its role in detection and surveillance.<\/jats:p>","DOI":"10.1055\/a-2576-7496","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:11:36Z","timestamp":1744157496000},"page":"e89-e91","source":"Crossref","is-referenced-by-count":4,"title":["Circulating Tumor DNA Testing for Detection and Surveillance of Sinonasal HPV-Associated Cancers"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0577-1635","authenticated-orcid":false,"given":"Avraham E.","family":"Adelman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Florida, Gainesville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1893-8235","authenticated-orcid":false,"given":"Kartik","family":"Motwani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Florida, Gainesville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Chapurin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Florida, Gainesville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1038\/s41571-022-00603-7","article-title":"HPV-associated oropharyngeal cancer: epidemiology, molecular biology and clinical management","volume":"19","author":"M Lechner","year":"2022","journal-title":"Nat Rev Clin Oncol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.1038\/modpathol.2016.189","article-title":"Virus-associated neoplasms of the nasopharynx and sinonasal tract: diagnostic problems","volume":"30","author":"J K Chan","year":"2017","journal-title":"Mod Pathol"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1001\/jamaoto.2024.1311","article-title":"Epidemiologic trends in human papillomavirus-associated sinonasal squamous cell carcinoma","volume":"150","author":"A Amanian","year":"2024","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"104243","DOI":"10.1016\/j.amjoto.2024.104243","article-title":"Evaluating human papillomavirus testing, prevalence, and association with prognosis in head and neck squamous cell carcinoma by subsite: a national cancer database study","volume":"45","author":"J Barlow","year":"2024","journal-title":"Am J Otolaryngol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"106855","DOI":"10.1016\/j.oraloncology.2024.106855","article-title":"Sinonasal squamous cell carcinoma in the United States: temporal and geographic patterns associated with HPV testing and positivity","volume":"154","author":"A Costantino","year":"2024","journal-title":"Oral Oncol"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"20220609","DOI":"10.3390\/cancers14122858","article-title":"Liquid biopsy in head and neck cancer: current evidence and future perspective on squamous cell, salivary gland, paranasal sinus and nasopharyngeal cancers","volume":"14","author":"S Cabezas-Camarero","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"04","key":"ref7","first-page":"20230214","article-title":"Analytical validation of NavDx, a cfDNA-based fragmentomic profiling assay for HPV-driven cancers","volume":"13","author":"A Gunning","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"ref8","first-page":"20190403","article-title":"Detection of early human papillomavirus-associated cancers by liquid biopsy","volume":"3","author":"R R Damerla","year":"2019","journal-title":"JCO Precis Oncol"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1001\/jamaoto.2023.1937","article-title":"Performance of liquid biopsy for diagnosis and surveillance of human papillomavirus-associated oropharyngeal cancer","volume":"149","author":"R M Ferrandino","year":"2023","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"19","key":"ref10","doi-asserted-by":"crossref","first-page":"3914","DOI":"10.1158\/1078-0432.CCR-23-1064","article-title":"Liquid biopsies with circulating plasma HPV-DNA measurements-a clinically applicable surveillance tool for patients with HPV-positive oropharyngeal cancer","volume":"29","author":"K K Jakobsen","year":"2023","journal-title":"Clin Cancer Res"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/PAS.0000000000002134","article-title":"Circulating tumor HPV DNA in patients with head and neck carcinoma: correlation with HPV genotyping","volume":"48","author":"K Mijares","year":"2024","journal-title":"Am J Surg Pathol"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1158\/1078-0432.CCR-21-3151","article-title":"Cell-free HPV DNA provides an accurate and rapid diagnosis of HPV-associated head and neck cancer","volume":"28","author":"G Siravegna","year":"2022","journal-title":"Clin Cancer Res"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1200\/JCO.19.02444","article-title":"Plasma circulating tumor HPV DNA for the surveillance of cancer recurrence in HPV-associated oropharyngeal cancer","volume":"38","author":"B S Chera","year":"2020","journal-title":"J Clin 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