Challenges in management of a patient with oropharyngeal carcinoma and scleroderma

Objective: To discuss some of the challenges that can arise in the treatment of patients with oropharyngeal carcinoma and scleroderma, by presenting an illustrative case. Methods: We report a case of a patient with scleroderma who was treated with surgery, radiation and systemic therapy for oropharyngeal squamous cell carcinoma. We also review the literature on treatment of head and neck squamous cell carcinoma (HNSCC) in scleroderma patients. Results: The patient tolerated treatment well, with a typical degree of toxicity and no evidence of recurrence at 3.5 years following adjuvant therapy. Conclusion: Patients with oropharyngeal cancer and scleroderma should be evaluated on a case-by-case basis in conjunction with a rheumatologist to determine the ideal treatment plan. Patients with limited or well-controlled scleroderma may tolerate treatment better than expected based on historical reports in the literature.