Atypical Presentation of a Pigmented Oncocytoma of the Caruncle: A Case Report
A 69-year-old woman was referred to the Ocular Oncology Service for the evaluation of a pigmented mass in the caruncular region of the right eye. The patient was regularly followed for chronic blepharoconjunctivitis in both eyes and dry eye syndrome, treated with lubricant eye drops. There was no history of eye surgery or trauma. The patient took daily medications for hypertension and was suspected to have rosacea. Aside from this, her personal medical history and family history were unremarkable.\nThe patient complained of a tan-colored lesion on her right caruncle, but denied symptoms of bleeding, discharge, an increase in size, or a color change of the lesion. On ocular examination, visual acuity was 20/20 and intraocular pressure was 16 mm Hg in both eyes. Slit lamp biomicroscopy revealed a well-circumscribed, partially pigmented lesion in the caruncle of the right eye. The lesion had a slightly lobulated surface with visible superficial vessels (fig. ). No involvement of the lacrimal system was noted, and the dilated fundus examination of both eyes was unremarkable. The patient was diagnosed with conjunctival nevus of the right caruncle.\nDue to the lesion's unfavorable location, the patient was advised to undergo complete surgical excision of the caruncular mass. The excised specimen was submitted for histo-pathological evaluation.\nHistopathological examination disclosed a benign, cystic, tubular, well-circumscribed lesion composed of tall, columnar, granular eosinophilic cells (fig. ). A thin fibrous tissue capsule penetrating the tumor from the periphery was also present. The pigmented macroscopic appearance of the lesion was thought to be due to concretions within the tumor (fig. ).\nA diagnosis of oncocytoma of the caruncle was made.