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Does human papilloma virus play a role in sinonasal inverted papilloma?

Govindaraj, Satish; Wang, Hailun

Current Opinion in Otolaryngology & Head and Neck Surgery: February 2014 - Volume 22 - Issue 1 - p 47–51
doi: 10.1097/MOO.0000000000000017
NOSE AND PARANASAL SINUSES: Edited by Samuel S. Becker and Nithin D. Adappa

Purpose of review Inverted papillomas are a benign sinonasal tumor with a propensity for recurrence and malignant transformation. Although many investigations have been made into the nature of this disease, its etiology and causes for malignant transformation have yet to be fully elucidated. It is the authors’ objective to present a review on management of the disease and evaluate the present relationship between human papilloma virus (HPV) and inverted papilloma.

Recent findings A causal relationship between HPV and the pathogenesis and progression of inverted papilloma has been posited since the 1980s. Although widely varied HPV detection rates have been reported, recent studies have noted a substantial increase in both recurrence and malignant transformation in HPV-infected inverted papillomas. However, exact cellular mechanisms by which infection leads to subsequent recurrence and development of carcinoma have yet to be elucidated.

Summary Evidence exists suggesting that HPV infection plays a role in the progression of inverted papilloma and confers an increased risk for recurrence and malignant transformation. PCR is the preferred detection method, and fresh or frozen specimens are the ideal source of tissue for evaluation. Although multiple studies have detected an association between HPV and inverted papilloma (both recurrent and malignant transformation), further studies are necessary to elucidate the underlying molecular pathways before an association can be changed to causation.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA

Correspondence to Satish Govindaraj, MD, FACS, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1191, 8th Floor, New York, NY 10029, USA. Tel: +1 212 241 9410; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins