Tumors of the caruncle: a clinicopathologic correlation.
OBJECTIVE
To determine the types and incidence of caruncular lesions and to investigate the correlation between clinical and histologic diagnosis.


METHODS
Retrospective, observational case series.


METHODS
Records of patients with a lesion of the caruncle that was excised and submitted to our ocular pathology department between January 1979 and May 2005 were reviewed. Lesions were classified by histologic type and correlated with patient age, gender, and preoperative clinical diagnosis.


RESULTS
A total of 195 consecutive caruncular lesions from 191 patients were identified. Twenty-four different types of lesions were identified; the most common were nevi (n = 92, 47%) and papillomas (n = 29, 15%). One keratoacanthoma was identified. One hundred eighty-three lesions (93.8%) were benign, six (3.1%) were premalignant, and five (2.6%) were malignant. Preoperative clinical diagnosis corresponded to postexcision histologic diagnosis in 73 cases (37.4%). Suspected malignancy was a common reason for excision (61 cases, 31.3%), but malignancy was confirmed in only three (4.9%) of 61 cases. Two of the five malignant lesions were clinically thought to be benign.


CONCLUSIONS
We hereby report the first caruncular keratoacanthoma. The rarity and variety of caruncular lesions make clinical diagnosis difficult. Malignancy is clinically overestimated, and some malignant lesions can take a benign aspect, justifying close photographic follow-up of all lesions. Because caruncular malignant melanoma is associated with poor prognosis, pigmented lesions should be monitored carefully. In the absence of clear criteria for malignancy, any change in color, size, or vascularization of a caruncular lesion should hasten excision.
Kaeser
Pierre-François
PF
Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Uffer
Sylvie
S
Zografos
Leonidas
L
Hamédani
Mehrad
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003229:Conjunctival Diseases / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D007636:Keratoacanthoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology / Q000601:surgery; D010212:Papilloma / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies