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HPV-associated OPSCC is shown by several prospective and retrospective studies to have a superior outcome after treatment with definitive radiation, chemoradiation or surgery when compared with their non-HPV associated counterparts. HPV-positive disease was also associated with a longer interval to distant metastases than HPV-negative disease, but patients with HPV-positive disease tended to have distant metastases to sites that are atypical for OPSCC. Loco-regional failure is even rarer for this disease entity. Here, we report a case of a locoregionally advanced p16+ SCCa of the oropharynx who had an orbital recurrence after receiving definitive chemoradiation.