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Rafael Reis Pereira, Rafael Frederico Peres, Patrick T Logan, Sérgio Burnier, Nabil Saheb, Aaron I Rosen, Miguel N Burnier; Frequency of Pediatric caruncular lesions: A 10-year clinicopathological study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2421.
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© ARVO (1962-2015); The Authors (2016-present)
The ocular caruncle is a modified cutaneous tissue located at the inner canthus that contains hair follicles, accessory lacrimal glands, sweat glands and sebaceous glands. Caruncular lesions are uncommon, especially in the pediatric population. As such, accuracy of clinical preoperative diagnosis in children is uncertain. The goal of this study is to evaluate the frequency and the characteristics of caruncle lesions in a pediatric population.
All ocular and periocular lesions in the Montreal Children's Hospital and Henry C. Witelson Ocular Pathology Laboratory databases were analyzed over a 10-year period (November 2006 to November 2016). Cases of caruncular lesions were correlated to age, gender, localization, size and other site involvement.
Of the 7311 patients analyzed, 785 had ocular or periocular lesions (10.74%). A total of 8 patients (1.0%) with 9 specimens showed caruncle involvement, 66.7% of which were female. The mean patient age was 10 years (range, 5–14 years). The lesions occurred on the left side in 55.5% (n=5) of cases, and one showed bilateral involvement. The sizes of the specimens ranged between 3x2 mm to 8x6 mm. The most frequent lesion present was compound nevus (n=5; 55.5%); two of these lesions presented with atypia. The second most frequent lesion was bilateral epithelioid hemangioma which presented in a patient with Kimura Disease (n=2; 22.2%). The other two cases represented a solid choristoma and sebaceous hyperplasia with chronic inflammation. No malignant lesions were found. Clinical diagnoses corresponded to the pathological diagnosis in 22.2% of cases.
Caruncle lesions in children are an uncommon finding. None of the lesions analyzed in this study were malignant. Melanocytic lesions were the most common in this particular location. Herein, we present the first report of bilateral epithelioid hemangioma of the caruncle in a child diagnosed with Kimura Disease. Due to the low clinical and pathological diagnostic agreement, it is important to be aware of the common features presented herein in order to ensure a rapid, accurate diagnosis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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