Occurrence of Buffalo Hump and Laryngeal Cancer in a HIV-1 Infected Patient with Metabolic Disorders Receiving a Rescue HAART Regimen

Reported cases of laryngeal squamous cell carcinomas are rare in HIV-1 infected patients. We describe a 68 year-old heavy smoker HIV-1 positive male receiving a salvage combination antiretroviral therapy, who developed a differentiated laryngeal cancer staging T3N0Mx after a 21 year history of HIV-1 infection. The patient also presented a severe fat redistribution with “buffalo hump” accompanied by subcutaneous adipose tissue lipoatrophy at arms and legs, and a dis-metabolic syndrome. Head and neck movements were severely limited by this voluminous mass. The presence of immune-suppression at the diagnosis with a relatively low grade staging of the neoplasm determined the choice of a combined chemo-radiation therapy, taking also in account the high infective risk linked to the surgery approach compared to that of acute toxicity reactions. A two years disease free follow up reinforced the needs of an early and accurate screening for neoplasms in HIV-1 infected patients.