Tumors of the caruncle: A clinicopathologic correlation
ABSTRACT To determine the types and incidence of caruncular lesions and to investigate the correlation between clinical and histologic diagnosis.
Retrospective, observational case series.
Records of patients with a lesion of the caruncle that was excised and submitted to our ocular pathology department between January 1979 and May 2005 were reviewed. Lesions were classified by histologic type and correlated with patient age, gender, and preoperative clinical diagnosis.
A total of 195 consecutive caruncular lesions from 191 patients were identified. Twenty-four different types of lesions were identified; the most common were nevi (n = 92, 47%) and papillomas (n = 29, 15%). One keratoacanthoma was identified. One hundred eighty-three lesions (93.8%) were benign, six (3.1%) were premalignant, and five (2.6%) were malignant. Preoperative clinical diagnosis corresponded to postexcision histologic diagnosis in 73 cases (37.4%). Suspected malignancy was a common reason for excision (61 cases, 31.3%), but malignancy was confirmed in only three (4.9%) of 61 cases. Two of the five malignant lesions were clinically thought to be benign.
We hereby report the first caruncular keratoacanthoma. The rarity and variety of caruncular lesions make clinical diagnosis difficult. Malignancy is clinically overestimated, and some malignant lesions can take a benign aspect, justifying close photographic follow-up of all lesions. Because caruncular malignant melanoma is associated with poor prognosis, pigmented lesions should be monitored carefully. In the absence of clear criteria for malignancy, any change in color, size, or vascularization of a caruncular lesion should hasten excision.
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ABSTRACT: Purpose: To report 2 cases of squamous cell carcinoma of the lacrimal caruncle. Methods: Two patients, a 38-year-old man and a 72-year-old woman, presented with a painful mass in the medial angle of the eyelid aperture, with signs of inflammation. Biopsy was performed in both cases. Results: Pathologic examination revealed a keratinized squamous cell carcinoma of the lacrimal caruncle in both cases. Conclusions: We report 2 more cases of the rarely found squamous cell carcinoma of the lacrimal caruncle.European journal of ophthalmology 12/2013; DOI:10.5301/ejo.5000399 · 1.06 Impact Factor
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ABSTRACT: To describe a case of sebaceous carcinoma of the caruncle and review relevant literature to raise awareness about this rare disease. A 63-year-old Chinese man presented with a nontender mass that had developed within the right lacrimal caruncle more than 3 years previously and had been growing in size. The patient was admitted to the hospital, and no systemic diseases were noted on physical and instrumental examinations. The mass was removed intact, and 10 small map biopsies of the surrounding conjunctiva and deeper tissues were performed. Thereafter, 0.04% mitomycin C was applied to the surgical defect for 5 minutes before repair by conjunctival autografting. The gross specimen was observed to be firm and yellow. Microscopic examination revealed that the tumor consisted of lobules, composed of pleomorphic vacuolated cells with central necrosis. The pathologic diagnosis was a well-differentiated sebaceous cell carcinoma of the caruncle that did not extend to the deep surgical margins. Moreover, no tumor recurrence was noted 12 months after surgery. The occurrence of sebaceous cell carcinoma in the caruncle is rare. In general, this neoplasm is often both clinically and histopathologically misdiagnosed as a benign condition, resulting in both a delay in correct diagnosis and increased morbidity and mortality. Therefore, this malignancy should be considered in the differential diagnosis of caruncular lesions. The suspected neoplasm should be removed by margins that are as wide as possible; map biopsies are considered to be useful to rule out the subclinical spread of the tumor.Optometry and vision science: official publication of the American Academy of Optometry 12/2013; DOI:10.1097/OPX.0000000000000154 · 2.04 Impact Factor
Article: Corneal Limbal Sebaceous Adenoma[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study was to describe a case of a corneal limbal sebaceous adenoma. An 83-year-old male patient presented with a white solid nodular lesion covering most of the cornea of his right eye. The corneal lesion was removed totally. The corneal surface was reconstructed by amniotic membrane transplantation. The histopathological examination of the lesion revealed the presence of a sebaceous adenoma. A systemic examination revealed no other abnormalities. Sebaceous adenomas on the ocular surface are known to be very rare. To the best of our knowledge, this is the first case of a sebaceous adenoma located on the cornea, reported in the literature. It is of vital importance to make a differential diagnosis of sebaceous adenomas of the eyelid and conjunctiva with the Muir-Torre syndrome associated with visceral malignancies.Cornea 02/2014; 33(4). DOI:10.1097/ICO.0000000000000075 · 2.36 Impact Factor