Human Papillomavirus: Possible Mechanisms of Damage in Sinonasal Inverted Papilloma

Sinonasal inverted papilloma (SNIP) is a benign neoplasm derived from the Schneiderian membrane and the endoderm of the ciliated respiratory epithelium of the nasal cavity and paranasal sinuses. SNIP is uncommon and typically found between the fourth and seventh decades of life, with men being more frequently affected. The medical significance of this benign neoplasm lies in its potential to cause local tissue destruction, tendency toward malignancy, and high recurrence rate. This study describes the histology of the nasosinusal mucosa and histological characteristics of SNIP, as well as its clinical manifestations and treatment. We also describe findings in the development of SNIP such as chronic inflammation and environmental factors. Additionally, we describe the association between cases positive for the human papillomavirus (HPV) and progression to malignancy and recurrence. This analysis includes the tumor microenvironment, encompassing the infiltration of immune cells such as CD4+ and CD8+ lymphocytes, macrophage polarization, and increases in certain metalloproteinases (MMP-2 and MMP-9). Finally, we address epigenetic alterations associated with HPV infection.