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. 2022 Sep:10:291-302.
doi: 10.1007/s40136-022-00404-7. Epub 2022 May 11.

Human Papillomavirus-Related Carcinomas of the Sinonasal Tract

Diana C Lopez  1   2 , Austin T K Hoke  1   3 , Lisa M Rooper  4 , Nyall R London Jr  1   5   6
Affiliations

Human Papillomavirus-Related Carcinomas of the Sinonasal Tract

Diana C Lopez et al. Curr Otorhinolaryngol Rep. 2022 Sep.

Abstract

Purpose of review: The sinonasal tract is home to a uniquely heterogenous collection of malignant tumors. Human papillomavirus (HPV) has been detected in a number of these, but the virus' role as an oncogenic driver or coincidental finding remains unclear. We aim to highlight five sinonasal tumor types and synthesize the prevalence, etiologic role, and known clinicopathologic relevance of HPV in each.

Recent findings: The last decade has seen an expansion of investigation into HPV's oncogenic and prognostic significance within sinonasal malignancies. The sinonasal tract poses challenges to HPV detection where p16 lacks value as an accurate surrogate. A growing body of data supports a potentially favorable clinical profile for certain sinonasal HPV-positive lesions.

Summary: HPV represents a potential biologically and clinically relevant factor for some sinonasal malignancies. Definitive conclusions regarding HPV's role as a potential oncogenic agent require routine testing using validated methodologies, genomic interrogation, and large-scale prospective studies.

Keywords: HPV-Related Multiphenotypic Sinonasal Carcinoma; Human Papillomavirus and Sinonasal Malignancies; Inverted Sinonasal Papilloma; Nasopharyngeal Carcinoma; Sinonasal Squamous Cell Carcinoma; Sinonasal Undifferentiated Carcinoma.

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Conflict of interest statement

Conflicts of Interest N. London receives research funding from Merck regarding HPV related sinonasal carcinomas. N. London holds stock in Navigen Pharmaceuticals and was a consultant for Cooltech Inc., neither of which are relevant to the present manuscript. All other authors declare no competing interests.

Figures

Figure 1.
Figure 1.
A. HPV associated SNSCC most commonly have non-keratinizing morphology (200x) and consistently show p16 overexpression (inset, 400x). B. HMSC is defined by the presence of both squamous and salivary differentiation (100x) and is frequently positive for HPV33 by RNA in-situ hybridization (inset, 400x). C. A subset of SNUC (200x) are also associated with high-risk HPV and can be differentiated from SNSCC by the absence of squamous differentiation using markers such as p40 (inset, 400x). D. A subset of nasopharyngeal carcinoma, frequently showing non-keratinizing morphology similar to SNSCC (100x) are also positive for high-risk HPV by RNA in-situ hybridization (inset, 400x).
See this image and copyright information in PMC

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      *This recent review provides a comprehensive overview of contemporary insight into the role of HPV in SNSCC and highlights gaps in the understanding of this relationship.

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