No expert here, but we're specifically talking about HPV-16, which 90% of the time it is if HPV cancer related, and to a lesser extent, HPV-18, which effects the oropharynx. There are cases of HPV-16 occurring in the oral tongue, to what extent is not sure, and some thought is it may be a misdiagnosis as oral tongue or a metasteses when it was in fact the oropharynx, BOT all along. HPV-16 can occurr in the nasopharynx and larynx also, but majority of cases is the oropharynx, and is where they should look for the primary. Treatment is pretty much the same for HPV positive or negative in the oropharynx, but in the oropharynx there is better response to treatment and prognosis, but that's only in the oropharyx, and no positive change in survival or response is seen outside this area. There are trials for treatment deescalation for HPV positive oropharynx cancer. If they did a surgical biopsy, they should still have a sample on file, frozen section, which can be tested for HPV.