Oncocitoma quístico papilar de carúncula lagrimal

La carúncula lagrimal forma parte de los anexos oculares y es asiento ocasional de neoplasias, las cuales en su mayoría son benignas. Dentro de estos tumores se encuentran los oncocitomas, los cuales están constituidos por células oncocíticas (oxifílicas) y poseen una baja incidencia con menos del 3 % de los tumores y bajos reportes de casos en la literatura. A pesar de que existen varios estudios en Cuba de tumores de anexos oculares no hay evidencia actualizada de casos con oncocitoma. Por ello se considera necesaria la presentación de este caso. Se trata de paciente blanca, femenina de 83 años de edad con antecedentes de hipertensión arterial, compensada bajo tratamiento y de carcinoma basocelular, operada hace siete años. Acudió por presentar aumento de volumen indoloro en el ángulo interno del ojo izquierdo. Al examen físico oftalmológico se observó lesión de 1 cm, gris-rosácea, bien delimitada. Se procedió a su exéresis con sospecha clínica de carcinoma basocelular y se envió espécimen para estudio anatomopatológico, el cual concluyó como oncocitoma quístico papilar (cistoadenoma papilar eosinofílico) de carúncula.

The lacrimal caruncle is part of the ocular adnexa and is the occasional seat of neoplasms, most of which are benign. Among these tumors are oncocytomas, which are constituted by oncocytic (oxyphilic) cells and have a low incidence with less than 3% of tumors and low case reports in the literature. Although there are several studies in Cuba of ocular adnexal tumors, there is no updated evidence of cases with oncocytoma. Therefore, it is considered necessary to present this case. The patient is a white, 83-year-old female with a history of arterial hypertension, compensated under treatment and basal cell carcinoma, operated seven years ago. She presented with painless enlargement of the inner corner of the left eye. Ophthalmologic physical examination revealed a 1 cm lesion, grayish-pinkish, well demarcated. The lesion was excised with clinical suspicion of basal cell carcinoma and the specimen was sent for anatomopathologic study, which concluded as papillary cystic oncocytoma (eosinophilic papillary cystoadenoma) of the caruncle.

Clinical and histopathological profile of primary caruncular lesions

Purpose: To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature. Methods: A retrospective review of all the caruncular lesions between January 2000 and January 2020 was done at a single tertiary eye care hospital. The lesions were classified as benign and malignant lesions. Clinicopathological correlation was done for the excised lesions. Results: A total of 87 caruncular lesions were included in the study. Males (59%) were affected more than females (41%). The mean age at presentation was 44 ± 20 years. The mean duration of complaint was 36 ± 62 months. A total of 36 patients underwent surgical excision whereas the rest opted for conservative management. Recurrence was noted in five patients. Fifteen different types of lesions were identified histopathologically. Benign lesions (78%) were far more common than malignant ones (22%). Epithelial inclusion cyst was the most common benign lesion and sebaceous gland carcinoma was the most common malignant lesion. Correct clinicopathological correlation was seen in 52.7% of the cases. Caruncular tuberculosis, oncocytoma, and basosquamous cell carcinoma were some of the rare lesions. Conclusion: Caruncular lesions are uncommon and very diverse, which makes clinical diagnosis challenging. Epithelial inclusion cyst and sebaceous gland carcinoma were the most common benign and malignant lesions respectively. Correct clinicopathological correlation was seen in more than half of the cases

Oncocitoma em carúncula: relato de caso / Oncocytoma of the caruncle: a case report

RESUMO O oncocitoma é um tipo de neoplasia rara na prática clínica e descrito na literatura, principalmente quando localizado no olho. Quando localizado nos anexos oculares, é mais frequentemente na carúncula. Analisou-se o caso de uma paciente de 74 anos, caucasiana, que relatou desconforto visual no olho esquerdo, e cujo exame físico mostrou lesão tumoral na carúncula esquerda, com volume moderado, presença de neovascularização e secreção excessiva. A excisão cirúrgica da lesão foi realizada sob sedação, e a peça foi enviada para avaliação anatomopatológica. A lesão foi diagnosticada histologicamente como oncocitoma, sem malignidade, e a paciente não apresentou recidiva após o procedimento. Embora raro, esse tumor deve ser reconhecido pelos oftalmologistas, devido ao risco já relatado de desenvolvimento de adenocarcinoma.

ABSTRACT Oncocytoma is a neoplasm rarely observed in clinical practice and reported in the literature, especially when located in the eye. When described in the ocular adnexa, it is most often located in the caruncle. The case of a 74-year-old Caucasian female patient is reported. She complained of visual discomfort in the left eye, and physical examination showed a tumoral lesion in the left caruncle, of moderate volume, presence of neovascularization, and excessive secretion. Surgical excision of the lesion was performed under sedation, and the specimen was sent for pathological examination. The lesion was histologically diagnosed as oncocytoma with no malignancy, and the patient presented no recurrence after the procedure. Although rare, this tumor must be recognized by ophthalmologists due to the risk of developing adenocarcinoma, as already reported.

Clinical application of locational partition of the nasal endsin lacerated lacrimal canaliculi / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the positional relationship between the nasal ends of the lacerated lacrimal canaliculi, lacrimal caruncle, and medial canthal ligament, as well as its application in the lacrimal canalicular anastomosis.<p>METHODS: Sixty-five patients with traumatic lower canalicular laceration were selected. The distance from the lacrimal punctum to the temporal end was measured. The nasal ends were found under direct vision, and the positional relationship between the nasal ends, lacrimal caruncle and medial canthal ligament were quantitatively analyzed.<p>RESULTS: Totally 65 patients with canaliculus laceration, 39 patients had a distance of less than 6mm from the lacrimal punctum to the temporal end, where the nasal ends of 35 patients were located in the lacrimal caruncle area. There were 26 cases in which the distance from the lacrimal punctum to the temporal end was greater than 6mm, where the nasal ends of 24 cases were located in the medial canthal ligament area. The vertical distance between the nasal ends in the lacrimal caruncle area and the lacrimal mucosa was 2.1±0.7mm, and the vertical distance between the nasal ends in the medial canthal ligament area and the skin edge was 3.5±1.2mm.<p>CONCLUSION: The positions of nasal ends can be divided into the lacrimal caruncle area and the medial canthal ligament area, providing a basis for finding the nasal ends of the lacerated lacrimal canaliculi in the clinical practice.

A Case of Steatocystoma Simplex and Sebaceous Gland Hyperplasia of the Bilateral Lacrimal Caruncle

PURPOSE: A case of bilateral lacrimal caruncle steatocystoma simplex and sebaceous gland hyperplasia, which rarely occurs in the periocular area, is reported. CASE SUMMARY: A 42-year-old female presented with a bilateral caruncular mass, which had been growing for a few months. A physical examination revealed soft, non-tender, rounded masses and no other ophthalmic findings. Under local anesthesia, the masses were completely excised. In the histopathological examination, a cystic mass containing a sebaceous gland in the stratified squamous epithelium cyst wall was found. A hyperplastic sebaceous gland and a dilated sebaceous gland duct were also found. Steatocystoma simplex and sebaceous gland hyperplasia, respectively, were diagnosed. There was no recurrence or complication after excision. CONCLUSIONS: Steatocystoma simplex and sebaceous gland hyperplasia are benign tumors that rarely occur in the lacrimal caruncle. They can be diagnosed and treated by complete excision. Steatocystoma simplex and sebaceous gland hyperplasia should therefore be considered as differential diagnoses of a lacrimal caruncle mass.

Benign Fibrous Histiocytoma.

Fibrous histiocytomas (FHs) are mesenchymal tumors that may be benign or malignant. Ocular involvement by FHs is infrequent and primarily limited to the orbit. Rarely, FHs can also involve the conjunctiva and perilimbal area. We report the case of a 38‑year‑old male with lid, conjunctival, and neck FHs. The diagnosis was confirmed by histopathology.

A Case of Conjunctival Myxoma Invading the Caruncle

PURPOSE: To report a rare case of conjunctival myxoma invading the caruncle. CASE SUMMARY: A 46-year-old man presented with a medical canthal conjunctival mass in his left eye. The mass was a semi-transparent, yellowish, movable mass 10 mm x 6 mm in size in the subconjunctival space. There was no pain and no tenderness. Excisional biopsy of the mass was performed. Histopathologic examination revealed findings suggestive of myxoma. CONCLUSIONS: Relatively transparent, movable, yellowish to pinkish conjunctival masses at medial canthal area without pain or tenderness can be diagnosed as myxoma on biopsy and myxoma can be seen at caruncle.

Caruncular Abscess Due to Actinomycosis

The authors report a caruncular abscess caused by actinomycosis. A 47-year-old woman was admitted with persistent purulent discharge from the caruncle of the left eye for a duration of six months. Excisional drainage was performed, and 'sulfur granules' were observed, consistent with actinomyces infection. Intraoperative lacrimal probing and irrigation were performed to confirm that the abscess and canaliculus were not connected. Oral and topical antibiotics were administered postoperatively; the lesion resolved with no evidence of recurrence, and the symptom improved.

Kimura Disease Involving a Caruncle

A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 x 0.5 x 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.

Kimura Disease Involving a Caruncle

A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 x 0.5 x 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.

Postoperative Neurogenic Blepharoptosis after Repair of a Medial Orbital Wall Fracture Using the Transcaruncular Approach

PURPOSE: We report a case of neurogenic blepharoptosis after reconstruction of a medial orbital wall fracture using the transcaruncular approach. CASE SUMMARY: A 13-year-old girl presented with left eyeball pain and binocular diplopia caused by trauma from falling. Orbital computerized tomography showed a blowout fracture of the left medial orbital wall, herniation of the orbital soft tissue into the ethmoid sinus, and a portion of the medial rectus muscle trapped in the fracture. The patient underwent successful reconstruction of the medial orbital wall using the transcaruncular approach. However, moderate blepharoptosis with functional loss of the levator palpebrae superioris muscle developed immediately after awaking from the anesthesia. The blepharoptosis was presumed to have developed due to postoperative edema; therefore, oral corticosteroid was prescribed. However, the blepharoptosis did not improve. No other ocular signs or symptoms were detected. Because neither the margin reflex distance (MRD1) nor the function of the levator palpebrae superioris muscle recovered after eight weeks of conservative treatment, surgical correction of blepharoptosis was performed under local anesthesia. The preaponeurotic fat, soft tissue, tarsal plate, and aponeurosis of the levator palpebrae superioris all appeared normal. The patient underwent maximal resection of the levator palpebrae superioris muscle and the blepharoptosis was alleviated two weeks after the operation.

A Case of Oncocytoma of the Caruncle

PURPOSE: To report a case of oncocytoma of the caruncle. CASE SUMMARY: A 63-year-old woman visited our clinic due to a mass in her left caruncle that developed five months prior to admission. At the time of her visit, her visual acuity was 0.8 in the right eye and 1.0 in the left eye, and there was a small mass in her left eye. She did not have any pain, and no discharge was apparent. All blood sample results were within the normal range. Also, we did not perform any radiologic studies. We administered systemic antibiotics and excised the mass from the caruncle of her left eye. Her biopsy read 'Oval cells with cytoplasm stuffed with eosinophilic granular material'. These findings are compatible with oncocytoma of the caruncle. CONCLUSIONS: The oncocytoma of the caruncle requires regular follow-up, which differs from the treatment plans for hemangioma, nevi, and cysts.

Thuya occidentalis 12 ch como variante de tratamiento de la carúncula uretral en Pinar del Río. Enero 2000 - diciembre 2005 / Thuja occidentalis 12ch as an option of treatment in urethral caruncule in Pinar del Rio- January 2000-December 2005

La Carúncula uretral es una enfermedad femenina. Hasta el momento actual, la indicación eficaz de tratamiento es el proceder quirúrgico o largos períodos de tratamientos estrogénicos. Se realizó estudio prospectivo, descriptivo analítico longitudinal, desde enero del año 2000 hasta diciembre del 2005, a un grupo de 46 pacientes, en el HCQ "León Cuervo Rubio" de Pinar del Río, con el objetivo de validar la aplicación de un medicamento homeopático, Thuya Occidentalis 12 CH, que entre otras indicaciones según patogenesia, tiene la de actuar sobre formaciones polipoideas o estructuras semejantes a la Carúncula uretral. Fue utilizada la estadística descriptiva y como método estadístico la media porcentual para el análisis de los resultados. Se encontró en el grupo coincidencia con la literatura en cuanto a edad y síntomas de presentación. Se magnifica el resultado de desaparición de la lesión antes de las tres semanas en el 92,8% de las pacientes El 85,7% de las pacientes sobrepasa el año de evolución sin aparición de recidivas del tumor y sus síntomas acompañantes. Se convierte en un tratamiento eficiente, no invasivo, aporta un método de diagnóstico diferencial con otras entidades.

Urethral Caruncle is a female disease. Even in current times the most effective treatments are surgical approach or long-term periods of estrogen. A prospective, descriptive, analytic-longitudinal study from January 2000 to December 2005 was carried out in a group of 46 patients at "León Cuervo Rubio" Hospital in Pinar del Río, aimed at validating the use of the homeopathic drug Thuya occidentalis 12 CH, that among other indications and according to the pathogeny, acts on polypoid formations or structures similar to urethral caruncle. Descriptive statistics was used, and percentage mean was taken as a statistic method to analyze the results; coinciding age and symptoms of presentation with medical literature. The result of the disappearence of the lesion was significant before three weeks in 92,8% of the cases, 85,9% of them surpass one year without relapses of the tumor or its symptoms. Becoming an efficient, non-invasive treatment and provinding a method of differential diagnosis with other entities.

Urethral caruncle occurring in a young girl: a case report

Urethral caruncles are the most common benign tumors in the female urethra, and are usually found in the posterior lip of the urethral meatus of post-menopausal women. It is very rare in young girls. Its etiology is unknown. We add a case of urethral caruncle occurring in a 2 year and 5 month-old girl's mid-urethra. We believe that further accumulation of unusual cases may be helpful in discovering the pathogenesis.

Sebaceous Adenoma in Medial Caruncle of the Eye: A case report

Sebaceous adenoma is a rare solitary or multiple yellow, circumscribed neoplasm consisting of sharply demarcated, proliferating lobules or irregular size and shape that are composed of three cell bypes: basal cells, mature and transitional sebaceous cells. We reported a case of extremely rare sebaceous adenoma arising in caruncle of the left eye in a 78-year-old female. A polypoid tumor nodule, measuring 0.6x0.5 cm, was noticed 6 months before resection. It was grayish white with granular surface. There is no evidence of associated visceral neoplasm. Histopathologically, it revealed a lobulated tumor, composed of equal amount of highly differentiated sebaceous and intermediate transitional epithelium with minor participation of basaloid cells. This tumor is thought to be the neoplasm of the sebaceous gland normaly present in the caruncle of the eye rather than ectopic origin.

Clinical Study on Urethral Caruncle / 대한비뇨기과학회지

Clinical observation was done on the 23 cases of urethral caruncle which were confirmed pathologically during the period from January 1965 to August 1976 and the following results were obtained. 1. Age distribution was between 8 and 81 years, showing the highest incidence in 31 to 60 years (18/23, 78.3%) and the mean age was 45.2 years. 2. Among them, 16 cases were telangiectatic type (16/23, 69. 6%), 4 were papillomatous type (4/23, 17.4%) and 3 were granulomatous type (3/23, 13.0%). 3. Most common location was posterior lip of the urethral meatus (20/23, 87.1%) but anterior lip 1 and combined 2 respectively. 4. Excision and electrofulguration were performed in all cases and one case of recurrence was noticed.