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

Research output: Contribution to journalArticle

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)
JournalVirchows Archiv
DOIs
StateAccepted/In press - Jan 1 2019

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Mitosis
Neoplasms
Papillomavirus Infections
Cellular Structures
Sexually Transmitted Diseases
Squamous Cell Carcinoma
Smoking
HIV
Hemorrhage
Neoplasm Metastasis
Carcinoma
Biopsy
Recurrence
Pain
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

Cite this

Zhang, D., Gonzalez, R. S., Feely, M., Umrau, K., Lee, H., Allende, D. S., ... Liu, X. (Accepted/In press). Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases. Virchows Archiv. https://doi.org/10.1007/s00428-019-02680-z
Zhang, Dongwei ; Gonzalez, Raul S. ; Feely, Michael ; Umrau, Kavita ; Lee, Hwajeong ; Allende, Daniela S. ; Karamchandani, Dipti M. ; Zaleski, Michael ; Lin, Jingmei ; Westerhoff, Maria ; Zhang, Xuchen ; Alpert, Lindsay ; Liao, Xiaoyan ; Lai, Jinping ; Liu, Xiuli. / Clinicopathologic features of Buschke-Löwenstein tumor : a multi-institutional analysis of 38 cases. In: Virchows Archiv. 2019.
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title = "Clinicopathologic features of Buschke-L{\"o}wenstein tumor: a multi-institutional analysis of 38 cases",
abstract = "Buschke-L{\"o}wenstein 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.",
author = "Dongwei Zhang and Gonzalez, {Raul S.} and Michael Feely and Kavita Umrau and Hwajeong Lee and Allende, {Daniela S.} and Karamchandani, {Dipti M.} and Michael Zaleski and Jingmei Lin and Maria Westerhoff and Xuchen Zhang and Lindsay Alpert and Xiaoyan Liao and Jinping Lai and Xiuli Liu",
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Zhang, D, Gonzalez, RS, Feely, M, Umrau, K, Lee, H, Allende, DS, Karamchandani, DM, Zaleski, M, Lin, J, Westerhoff, M, Zhang, X, Alpert, L, Liao, X, Lai, J & Liu, X 2019, 'Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases', Virchows Archiv. https://doi.org/10.1007/s00428-019-02680-z

Clinicopathologic features of Buschke-Löwenstein tumor : a multi-institutional analysis of 38 cases. / Zhang, Dongwei; Gonzalez, Raul S.; Feely, Michael; Umrau, Kavita; Lee, Hwajeong; Allende, Daniela S.; Karamchandani, Dipti M.; Zaleski, Michael; Lin, Jingmei; Westerhoff, Maria; Zhang, Xuchen; Alpert, Lindsay; Liao, Xiaoyan; Lai, Jinping; Liu, Xiuli.

In: Virchows Archiv, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinicopathologic features of Buschke-Löwenstein tumor

T2 - a multi-institutional analysis of 38 cases

AU - Zhang, Dongwei

AU - Gonzalez, Raul S.

AU - Feely, Michael

AU - Umrau, Kavita

AU - Lee, Hwajeong

AU - Allende, Daniela S.

AU - Karamchandani, Dipti M.

AU - Zaleski, Michael

AU - Lin, Jingmei

AU - Westerhoff, Maria

AU - Zhang, Xuchen

AU - Alpert, Lindsay

AU - Liao, Xiaoyan

AU - Lai, Jinping

AU - Liu, Xiuli

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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