Caruncular lesions in Denmark 1978-2002: a histopathological study with correlation to clinical referral diagnosis

Purpose: To carry out a retrospective clinicopathological evaluation of caruncular lesions. Methods: Data were collected from all surgically removed and histopathologically evaluated caruncular lesions registered by Danish pathology departments during the 25-year period 1978-2002. Results: A total of 574 caruncular lesions were identified. The number of caruncular lesions increased significantly during the 25-year period. This was due to an increase in the number of benign lesions, whereas the number of premalignant and malignant lesions remained constant. A total of 550 (96%) of the lesions were benign. Naevus (n = 248, 43%) and papilloma (n = 131, 23%) were the most common neoplasms. Premalignant lesions (n = 10, 1.7%) were dominated by primary acquired melanosis (PAM) with atypia and epithelial dysplasia. Malignant lesions constituted a total of 14 neoplasms (2.4%), with basal cell carcinoma (n = 4, 0.7%) and lymphoma (n = 4, 0.7%) being the most frequent. The preoperative clinical diagnosis was correct in 286 (50%) of cases. Conclusion: Caruncular lesions are predominately benign but the lesions are rare and diverse, making clinical diagnosis difficult. Referral of excised lesions for pathological examination is recommended.