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Nish Patel, Thomas A Lazzarini, David T Tse, Thomas Johnson, Sara T. Wester, Sander R Dubovy; Oncocytoma of the Ocular Adnexa: Clinicopathologic Analysis of 24 Cases. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4672.
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© ARVO (1962-2015); The Authors (2016-present)
Oncocytomas, benign tumors of eosinophilic epithelial cells, may arise in many organs including the kidney, thyroid gland, salivary gland, and rarely, in the ocular adnexa. In this study, we conduct a retrospective, clinicopathologic analysis of 24 cases of oncocytoma of the ocular adnexa.
The database of the Florida Lions Ocular Pathology Laboratory at the Bascom Palmer Eye Institute was searched for specimens with a histopathologic diagnosis of oncocytoma from January 1998 through November 2019. Diagnoses were determined from light microscopic examination of paraffin embedded, formalin fixed tissue. The clinicopathologic features of each case were then assessed.
24 cases of oncocytoma of the ocular adnexa were identified within the aforementioned time period. The majority (18/24, 75.0%) of cases were present in the conjunctiva; 17 (70.1%) were present in the caruncle, and one (4.2%) was present in the fornix. Three (12.5%) cases were present in the lacrimal sac, two (8.3%) were present in the lower lid, and one (4.2%) was present in the orbit. The mean age at diagnosis was 73.2 years. Thirteen of the patients were male, and 11 were female. 15 cases were present on the right, and nine were present on the left. Many of the lesions appeared vascular while others were cystic or pigmented. Some patients experienced irritation while others were asymptomatic. Histopathology of the lesions demonstrated tumors composed of eosinophilic cells arranged in a glandular configuration with no morphologically malignant features, consistent with the diagnosis of a benign oncocytoma. Clinical and histopathology images of an oncocytoma in a 78-year-old female who presented with irritation from a caruncular lesion growing for three months are shown in Figures 1-2.
This is the largest case series of clinicopathologic features of oncocytomas of the ocular adnexa. These tumors are rare entities, but when present, most often manifest in the caruncle. Therefore, it is important to consider the possibility of an oncocytoma especially when faced with a caruncular lesion.
This is a 2020 ARVO Annual Meeting abstract.
Figure 1. Slit lamp photograph of the patient’s left eye: A fleshy, vascular lesion is present in the caruncle.
Figure 2. Histopathology of lesion of left caruncle (Hematoxylin-eosin; Original magnification x 400): Large eosinophilic, epithelial cells are identified in a glandular configuration, consistent with an oncocytoma.
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