Evidence that human papillomavirus causes inverted papilloma is sparse

Area of Science:

• Otolaryngology
• Oncology
• Pathology

Background:

• The role of human papillomavirus (HPV) in the pathogenesis of inverted papilloma remains debated.
• Understanding HPV prevalence in early-stage inverted papilloma is crucial for clarifying its etiology.

Purpose of the Study:

• To determine the prevalence of HPV in nondysplastic inverted papilloma.
• To compare HPV detection rates in inverted papilloma with those in the general population and other HPV-related neoplasias.

Main Methods:

• A case series of 36 inverted papilloma patients (2005-2012) was analyzed for smoking history, dysplasia, and HPV presence using in situ hybridization.
• A Medline literature review assessed HPV prevalence in inverted papilloma without moderate or severe dysplasia.

Main Results:

• HPV was detected in only 2.7% of the studied inverted papilloma cases.
• Literature review indicated HPV in 16.4% of inverted papilloma without dysplasia, compared to 4.2%-11.4% in the general population and 85%-95% in HPV-related neoplasias.
• Smoking was prevalent, with 55% of patients being active or former smokers.

Conclusions:

• Low HPV detection rates in inverted papilloma suggest it is not the primary cause.
• Inflammatory processes and environmental factors like smoking are proposed as more likely initiators of inverted papilloma.
• The metaplasia in inverted papilloma may predispose it to secondary HPV infection.