Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases

Dongwei Zhang, Raul S. Gonzalez, Michael Feely, Kavita Umrau, Hwajeong Lee, Daniela S. Allende, Dipti M. Karamchandani, Michael Zaleski, Jingmei Lin, Maria Westerhoff, Xuchen Zhang, Lindsay Alpert, Xiaoyan Liao, Jinping Lai, Xiuli Liu

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1 Scopus citations

Abstract

Buschke-Löwenstein tumor (BLT) is a rare sexually transmitted disease, mostly described in clinical literature as case reports or small series. Here, we investigated the clinicopathologic features of BLT in a total of 38 cases retrieved from multiple academic institutions. The average age was 47.6 ± 12.8 (mean ± SD) years old at diagnosis. The male to female ratio was 4.4:1. Common presenting symptoms were pain/discomfort, bleeding, mass lesion, and discharge. It was frequently linked to smoking and positive human immunodeficiency virus status. The tumor size and thickness were 8.5 ± 6.6 cm and 1.5 ± 1.3 cm, respectively. Histologically, 19 (50%) cases had an invasive squamous cell carcinoma component and were associated with high-risk human papillomavirus infection. There was no lymphovascular or perineural invasion, or nodal metastasis at initial diagnosis. BLTs with invasion had higher frequency of dyskeratosis, neutrophilic microabscesses, and abnormal mitoses, but lower frequency of pushing border compared with BLTs without invasion. All patients underwent wide excision, and some also received chemoradiation therapy. After a median follow-up of 23 months (range 1–207), the recurrence rate was 23.7% and disease-specific mortality was 2.6%. In summary, we presented the largest case series of BLT to date to characterize its unique clinicopathologic features. Our study indicated that certain histologic features such as dyskeratosis, neutrophilic microabscess, and abnormal mitosis in the non-invasive portion may be important clues on lesional biopsy to predict the presence of underlying invasive carcinoma.

Original languageEnglish (US)
Pages (from-to)543-550
Number of pages8
JournalVirchows Archiv
Volume476
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • Buschke-Löwenstein tumor
  • Human papillomavirus
  • Invasive squamous cell carcinoma
  • Prognosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

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  • Cite this

    Zhang, D., Gonzalez, R. S., Feely, M., Umrau, K., Lee, H., Allende, D. S., Karamchandani, D. M., Zaleski, M., Lin, J., Westerhoff, M., Zhang, X., Alpert, L., Liao, X., Lai, J., & Liu, X. (2020). Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases. Virchows Archiv, 476(4), 543-550. https://doi.org/10.1007/s00428-019-02680-z