Abstract
Purpose :
The caruncle is a conjunctival area located in the inner canthus, composed of stratified squamous epithelium, containing hair follicles, accessory lacrimal glands, sebaceous and sweat glands. Caruncular lesions are uncommon and often misdiagnosed, therefore presenting a challenge for ophthalmologists. The purpose of this study is to describe the clinical and pathological characteristics of the caruncle tumors.
Methods :
A total of 52 caruncular tumors were diagnosed among 6828 ocular lesions received at The MUHC-McGill University Ocular Pathology & Translational Research Laboratory (May 2006 to May 2018). For each of the caruncular tumors, an H&E, PAS and an immunohistochemical panel, when necessary, were evaluated for a final diagnosis. The clinicopathological features were correlated for all the caruncular tumors.
Results :
The 52 caruncular tumors represent approximately 2.0% of all ocular lesions. The vast majority of these tumors were benign (94.23%). Caruncular tumors were slightly more prevalent in men (53.85%). The lesions were most frequent in the age group between 40 and 65 years (34.62%). The most prevalent tumor type were benign melanocytic lesions (40.38%), followed by non-melanocytic tumors (30.77%). All benign melanocytic lesions were classified as nevi. Cystic epithelial tumors accounted for 15.38%. Squamous cell papilloma (15.38 %), oncocytomas (7.69%) and sebaceous adenoma (3.85%) were also observed. Other diagnoses such as MALT lymphoma and lymphoid hyperplasia, intraepithelial neoplasia, capillary hemangioma, choristoma and hamartoma presented a similar and less significant value (1.92%).
Conclusions :
The rarity and variety of caruncular lesions presents a challenge for ophthalmologists and may lead to misdiagnosis. Large series provide further information and clinicopathological characteristics for a final accurate diagnosis. Nevi followed by solid and cystic epithelial tumors are the most prevalent lesions. Special attention should be given to the presence of MALT lymphoma and intraepithelial neoplasia which are malignant lesions in this particular location.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.