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Cameron Oliver, Sabrina Bergeron, Jacqueline Coblentz, Ana Beatriz Toledo Dias, Julia Burnier, Miguel N Burnier; A unique recurrent bilateral presentation of oncocytomas of the caruncle. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3569.
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Oncocytoma of the ocular adnexa is a rare, benign epithelial neoplasm. It most often affects the caruncle unilaterally, and rarely recurs following surgical excision. Documented recurrences have been limited to the lacrimal sac and eyelid. We report a series of 8 cases of periocular oncocytoma, including the first case of a recurrent bilateral oncocytoma of the caruncle.
This is a case study including histopathologically confirmed cases of oncocytoma retrieved from the MUHC - McGill University Ocular Pathology & Translational Research Laboratory between 2006 and 2018. The data collected includes patient demographics, tumor laterality and location, histopathologic features, and final diagnosis.
A total of eight lesions from seven patients were studied. Histopathological features included eosinophilic oncocytic differentiation of epithelial cells, cystic spaces and absence of cellular atypia. Five patients were male and three were female; the mean age at time of excision was 81 (range 69 – 91; SD = 7.74). The majority of cases involved the caruncle (n = 5, 62.5%), two involved the conjunctiva (25%), and one involved the lower eyelid (12.5%). There was no significant predominance for the right or left eye; bilaterality was reported in one case. In this particular case, the histopathologic features were similar in both biopsies. Two cases involved the right caruncle of the same patient – first in 2008, then again in 2018 – suggesting a local late recurrence. Clinically, tumors presented as a mass in seven of eight cases (87.5%). Tumor biopsy dimensions were reported for 6 out of 8 cases, the smallest being 2 x 1 x 1 mm and the largest 5 x 5 x 3 mm. The largest tumor corresponds to the recurrent lesion.
Oncocytoma of the ocular adnexa is a rare tumor that commonly involves the caruncle, unilaterally. It presents as a mass, while the patient remains asymptomatic. Surgical excision is usually curative, with rare cases of recurrence involving the lacrimal sac and eyelid. This case series provides the first evidence of recurrence of oncocytoma of the caruncle. Additionally, the first case of bilateral oncocytoma of the ocular adnexa is reported. Size of the lesion is an important clinical indication for recurrences. It is recommended to include oncocytoma in the differential diagnosis of a caruncular lesion even when bilateral or recurrent.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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