Atypical Presentation of a Pigmented Oncocytoma of the Caruncle: A Case Report

Nicola, Maura Di; Miserocchi, Elisabetta; Rizzo, Nicola; Grantoza, Charlene L.; Bandello, Francesco; Modorati, Giulio

doi:10.1159/000353222

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…22 This coloration has been attributed to the Tyndall effect triggered by the luminal contents or concretions of partially cystic oncocytomas. 23 In the current lesion, the PAS stain revealed loose and pale staining luminal material, in which were suspended more compact, inspissated, and deeply staining fragments. It is postulated that the abundance of lipofuscin coupled with the contributions of inspissated luminal concretions probably produced the lesion's central dark blue-black coloration.…”

Section: Discussionmentioning

confidence: 68%

Pigmented Caruncular Apocrine Hidrocystoma With Oncocytic Features

Stagner

Colby

2017

Ophthalmic Plastic &Amp; Reconstructive Surgery

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An unprecedented pigmented caruncular apocrine hidrocystoma with the additional feature of an oncocytic transformation of the cyst's lining cells is reported. Over a year, a 79-year-old woman developed a centrally pigmented lesion of her right caruncle with translucent borders. Because of concern about a melanoma, a carunculectomy with adjunctive cryotherapy and placement of an amniotic membrane graft were performed, and the excised specimen was evaluated microscopically. A large cyst dominated the caruncle and was lined by an inner layer of columnar eosinophilic and granular cells with an outer, interrupted layer of flattened myoepithelial cells. Phosphotungstic acid hematoxylin staining disclosed myriad cytoplasmic, dot-like mitochondria signifying an oncocytic change. Immunohistochemistry revealed gross cystic fluid disease protein-15 and cytokeratin 7-positivity indicative of apocrine differentiation. Oncocytic change is characteristically encountered in lacrimal ductal cysts and tumors.

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Section: Discussionmentioning

confidence: 68%

Pigmented Caruncular Apocrine Hidrocystoma With Oncocytic Features

Stagner

Colby

2017

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…The solid, cellular portion is composed of epithelial cells filled with granular eosinophilic cytoplasm reflecting the presence of myriad mitochondria, whereas the cystic portion is filled with proteinaceous fluid and occasionally blood. The pigmented appearance has been presumed to arise from dense concretions within the tumor, rather than intracellularly [14]. In this case, the copious cystic portion was likely responsible for the macroscopic appearance that mimicked melanoma.…”

Section: Discussionmentioning

confidence: 90%

“…Of the 36 cases in which oncocytoma coloration was reported, 47% were described as orange-red, 19% dark blue, 19% tan-yellow, and 14% reddish-brown [4]. The differential diagnosis of pigmented caruncular mass includes caruncular nevus, melanoma, melanosis, oncocytoma, hemorrhage, and inclusion cyst [4,14]. Regarding melanoma, caruncular involvement is a predictor of poor prognosis, so the presence of a large darkly pigmented mass in the ocular adnexa should warrant suspicion for malignant melanoma [5,15].…”

Section: Discussionmentioning

confidence: 99%

Caruncular Oncocytoma Mimicking Malignant Melanoma

et al. 2017

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Purpose: To report a case of pigmented caruncular oncocytoma that simulated malignant melanoma and discuss the associated ultrasonographic and pathologic features. Method: Case report. Results: An 81-year-old female presented with a painless caruncular mass with a smooth brown surface suspicious for melanoma. Ultrasound biomicroscopy revealed a round mass with a large central cavity, more suggestive of a cystic rather than solid lesion. Following complete surgical resection, histopathology revealed a cystadenomatous lesion composed of bland cells with copious eosinophilic cytoplasm consistent with oncocytoma that had a central blood-filled cavity. Conclusions: Oncocytoma is a benign tumor that can appear pigmented clinically and resemble melanoma. The definitive diagnosis requires histopathologic evaluation. Oncocytoma should be considered in the differential diagnosis of a pigmented caruncular mass.

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“…In particular, lipofuscin pigments were characteristic in this case. Up to now, atypical features of oncocytomas include brownish pigmentation as well as feeder vessels, keratinization, and pedunculated and lobulated growth patterns [16, 17], but they have not been reported in the adrenal gland.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a pigmented oncocytoma has not yet been reported in the adrenal gland, and it is also a very rare condition in other sites [16, 17]. Therefore, we present this exclusive case of the coexistence of an ACO and ganglioneuroma in the left adrenal gland [25].…”

Section: Discussionmentioning

confidence: 99%

Adrenal Collision Tumor: Coexistence of Pigmented Adrenal Cortical Oncocytoma and Ganglioneuroma

Lee

Choi

Kim

et al. 2016

Case Reports in Surgery

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Background. Adrenal collision tumors (ACTs), in which distinct tumors coexist without intermingling in the same adrenal gland, are rare and their actual prevalence is unknown. ACTs commonly consist of adrenal cortical adenoma, pheochromocytoma, or metastatic malignant tumor. Case Report. A 32-year-old woman who had been experiencing gastric discomfort for one month was referred to our hospital with abnormal imaging findings. The physical examination and the laboratory data including endocrine studies were unremarkable. Abdomen computed tomography (CT) and magnetic resonance imaging (MRI) showed two adjacent masses in the left suprarenal fossa, and a laparoscopic left adrenalectomy was done. Histological and immunohistochemical (IHC) examinations revealed two distinct tumors: a pigmented adrenal cortical oncocytoma (ACO) and a ganglioneuroma, respectively. Conclusion. Both tumors are rare in the adrenal gland and exist as ACTs only exceptionally rarely. This is the first reported case of coexisting oncocytoma and ganglioneuroma in the same adrenal gland to our knowledge.

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Atypical Presentation of a Pigmented Oncocytoma of the Caruncle: A Case Report

Cited by 6 publications

References 10 publications

Pigmented Caruncular Apocrine Hidrocystoma With Oncocytic Features

Pigmented Caruncular Apocrine Hidrocystoma With Oncocytic Features

Caruncular Oncocytoma Mimicking Malignant Melanoma

Adrenal Collision Tumor: Coexistence of Pigmented Adrenal Cortical Oncocytoma and Ganglioneuroma

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