Clinical Features and Recurrence Risk of Human Papillomavirus–Related Pharyngeal Papilloma: A Retrospective Study

Objective The association between pharyngeal papilloma and human papillomavirus (HPV) remains unclear. Although previous studies have suggested that HPV involvement is unlikely, we encountered HPV‐positive cases, particularly in patients with multiple lesions, malignancy, or recurrence. This study aimed to clarify the relationship between HPV infection and clinicopathological features of pharyngeal papilloma, including recurrence and malignant transformation. Study Design Retrospective study. Setting Department of Otolaryngology–Head and Neck Surgery, Nihon University Hospital, a single tertiary referral center in Tokyo, Japan. Methods We retrospectively reviewed HPV‐DNA test results and clinical data from 69 patients with pharyngeal papilloma who underwent surgical resection between August 2006 and September 2018. Koilocytosis was histologically assessed, and associations between HPV status and recurrence, multiplicity, and malignant transformation were analyzed. Results Among 69 patients, 5 (7.2%) were HPV‐positive, including four (5.8%) low‐risk types (6, 11) and 1 (1.4%) high‐risk type (16). Koilocytosis was observed in 88% of cases. HPV‐positive cases had higher recurrence, multiplicity, and malignant transformation rates compared with HPV‐negative cases. Conclusion HPV DNA was detected in 7.2% of cases. HPV‐positive papillomas showed higher recurrence and malignanct transformation rates. Detection of HPV DNA may serve as a prognostic factor, and koilocytosis in HPV‐negative cases may reflect prior transient HPV infection.