Transitional papilloma of the nasal cavity and paranasal sinuses. Clinical course, viral etiology and malignant transformation.

Transitional papilloma is a rare but not uncommon tumor with an overall incidence varying between 0.5 and 4% of all primary nasal tumors. The probability of recurrence is high, between 20 and 62%, even after adequate therapy. Malignancies are associated with transitional papilloma in 2-13% of cases. A series of 21 patients with transitional papilloma of the nose and/or paranasal sinuses is presented. Human papillomavirus (HPV) structural proteins and DNA types were found in 13 cases (62%) of transitional papillomas studied. None of the 9 nasal polyps and none of the 9 squamous cell carcinomas of paranasal sinuses studied as control material contained HPV DNA. We found 4 recurrent papillomas (19%) during the 2-year observation time. All recurrences were HPV-positive. The incidence of malignant transformation was 14% in this series. Treatment of transitional papilloma is always surgical. In our opinion medial maxillectomy and ethmoidectomy via sublabial rhinotomy is the surgery of choice in the treatment of transitional papilloma.