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Early-detection demo · Head & Neck cancer

HPV-positive oropharyngeal SCC at NI-RADS 3

1.8 cm right tonsillar mass with 2.5 cm cystic level-II neck node — HPV-positive oropharyngeal SCC.

Patient: Marcus J · 56 · former smokerModality: MRIRisk: high · 70/100
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01

Risk profile

What OCTON knew before the scan
Risk
70
high
Tier
high
Persistent right-sided sore throat × 6 weeks · lateral cervical lymphadenopathy · HPV-16 positive on serology · 18 pack-year history (quit 5 yr ago).
Contributing factors
  • HPV-16 ++30
  • Persistent unilateral sore throat > 3 weeks+14
  • Tobacco use 18 pack-years+14
  • Heavy alcohol prior 10 yr+8
  • Age 56+4
Narrative

HPV-16-driven oropharyngeal SCC has a much better prognosis than HPV-negative disease (5-year OS 80%+ vs ~50%). NI-RADS 3 reads warrant urgent biopsy.

02

Scan + AI report

What MRI found · MRI head/neck with contrast (T1+C, T2 STIR, DWI)
MRI · DEMO
NI-RADS 3
OCTON · scanning · live
conf 0.85
OCTON Impression · 85% confidence

1.8 cm enhancing mass at the right tonsillar pillar with restricted diffusion. Adjacent 2.5 cm cystic level-II lymph node. NI-RADS 3.

Findings
  • 1.8 cm enhancing mass · right tonsillar pillar · Right oropharynx18 mm
  • Cystic level-II right cervical node, 2.5 cm · Right neck level II
  • DWI restriction in primary + node · Both
Differential diagnosis
  • HPV-positive oropharyngeal SCC78%
  • Lymphoma (Waldeyer's ring)10%
  • Tonsillar abscess with reactive node8%
  • Metastatic SCC unknown primary4%
Recommended actions
  • ▸Urgent ENT panendoscopy + tonsillectomy biopsy
  • ▸p16 IHC + HPV-DNA testing reflex
  • ▸PET-CT for staging (TNM 8th)
  • ▸Multidisciplinary head & neck tumor board
Caveats
  • p16-positive (HPV-driven) tumours have favorable prognosis but warrant escalation if persistent.
  • Smoking + HPV combination predicts intermediate prognosis vs. HPV alone.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
Flexible laryngoscopy
FrequencyPer ENT plan
Startsage 30
NCCN Head & Neck v1.2025
Monitoring
MRI head/neck + PET-CT staging
FrequencyOnce at diagnosis
Startsage 18
NI-RADS 2018
Monitoring
Post-treatment NI-RADS surveillance MRI
FrequencyEvery 3 months Y1, q6 mo Y2-3
Startsage 18
ASCO 2022
04

What changed

The early-detection win

A 6-week sore throat triggered MRI head/neck — NI-RADS 3 + HPV+ status routes the patient to a high-survival HPV-driven SCC pathway.

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