Caruncular Oncocytoma Mimicking Malignant Melanoma

Surakiatchanukul, Thamolwan; Sioufi, Kareem; Pointdujour-Lim, Renelle; Eagle, Ralph C.; Shields, Jerry A.; Shields, Carol L.

doi:10.1159/000468524

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…In addition, a pigmented oncocytoma has also been reported before with the pigmentation having been attributed to dense concretions within the tumor [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 97%

Clinico-pathological correlation of lacrimal caruncle tumors: a retrospective analysis over 22 years at the University Eye Hospital Bonn

Clemens

Loeffler

Holz

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose The lacrimal caruncle is composed of numerous structures including different glands as well as hair follicles. Accordingly, the spectrum of benign and malignant lesions is broad, and the clinical diagnosis is often challenging. Here we systematically analyzed excised caruncular tumors over the past 22 years with special emphasis on the clinico-pathological correlation to provide a guidance for clinicians. Methods Retrospective evaluation with clinico-pathologic correlation of surgically removed caruncular tumors between 1998 and 2020 at a tertiary referral center. Results Eighty-two caruncular tumors were identified in the respective period. The patients were between 11 and 85 years of age (mean, 46.8 years; median, 49 years). Nevi (n = 35), cystic lesions (n = 14), oncocytoma (n = 9), papilloma (n = 8), sebaceous gland hyperplasia (n = 8), and reactive lymphoid hyperplasia (n = 4) were observed most frequently. Besides, we are the first reporting herniated orbital fat accompanied by a pyogenic granuloma. 2.4% (n = 2) were malignant tumors (sebaceous gland carcinoma, conjunctival intraepithelial neoplasia with pyogenic granuloma). Conclusion Caruncular tumors show a broad spectrum of mostly benign tumors. They can occur in patients of any age. However, 8/9 oncocytomas and both malignant lesions were detected in patients older than 60 years. Although the clinical diagnosis was confirmed in only 68.3% by the histopathological analysis, the two malignant lesions were identified as such already clinically. Caruncular lesions with a history of growth or other signs of malignancy should be excised followed by detailed histopathological examination to allow a final diagnosis and exclude rare malignant tumors with lethal potential.

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“…In addition, a pigmented oncocytoma has also been reported before with the pigmentation having been attributed to dense concretions within the tumor [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 97%

Clinico-pathological correlation of lacrimal caruncle tumors: a retrospective analysis over 22 years at the University Eye Hospital Bonn

Clemens

Loeffler

Holz

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…They are often cystic and the proteinaceous contents of the cysts may cause the tumor to appear pigmented. [ 7 8 ] Malignant cases have not been described and simple excisional biopsy is curative. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

Oncocytic lesions of the ocular adnexa

Heathcote

Archibald

Valenzuela³

2021

Saudi Journal of Ophthalmology

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Oncocytic lesions may be metaplastic, hyperplastic, or neoplastic and occur in a variety of tissues, including those of the ocular adnexa. Oncocytes are enlarged epithelial cells with abundant eosinophilic granules in the cytoplasm, which represent large mitochondria with distorted cristae. The causes of oncocytic lesions remain uncertain, although in some sites such as the lacrimal sac, chronic inflammation may be a factor. Oncocytic neoplasms in all adnexal sites are generally benign (oncocytoma/oncocytic adenoma) and oncocytic adenocarcinomas are uncommon. Research into oncocytic neoplasms, particularly of the kidney and thyroid, has shed some light on the complicated genomic and metabolic changes that are associated with mitochondrial dysfunction in such neoplasms. The major driver event is mutation of mitochondrial DNA-encoding subunits of complex I in the respiratory chain. The subsequent metabolic events may promote tumorigenesis and inhibit malignant transformation. This review discusses the histopathology and histogenesis of two examples of oncocytoma in the ocular adnexa and presents a simplified synopsis of the genomic and metabolic changes that are significant in the pathogenesis of these neoplasms.

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“…This report builds on a table initially provided by Say et al 1 and includes all new cases reported within the past 11 years (Table 1). Thirty-seven cases 3,7–34 were obtained for inclusion through a PubMed literature search with the following key words: ocular oncocytoma, lacrimal oncocytoma, oncocytoma caruncle, oncocytoma eyelid, orbital oncocytoma, and eye oncocytoma.…”

Section: Discussionmentioning

confidence: 99%

Unusual Case of a Caruncular Oncocytoma

Vaidya

Simpson

Phillips

et al. 2021

The American Journal of Dermatopathology

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Oncocytomas are benign neoplasms that are most often found in the salivary glands and kidneys. Ocular oncocytoma typically present as an asymptomatic dark blue papule on the lacrimal caruncle. Histologically, the tumor is composed of oncocytes, cells notable for eosinophilic cytoplasmic granules representing large quantities of dysfunctional mitochondria. The neoplastic proliferation may be partially or totally encapsulated and may be surrounded by myoepithelial cells. Discussed is the pathophysiology and histopathology of an ocular oncocytoma from the right lacrimal caruncle of a 68-year-old man. The patient complained of a foreign body sensation and tearing associated with a purpuric 1 • 1-mm papule of the right caruncle that had been present for 6 months. An excisional biopsy showed an oxyntic neoplasm with small cystic glandular spaces associated with goblet cells and mucin, confirmed by mucicarmine stain. Given the rarity of ocular oncocytomas and presence of mucin, exclusion of an endocrine mucin-producing sweat gland carcinoma was necessary. Peripheral myoepithelial cells noted on p63 immunostaining are seen in both endocrine mucinproducing sweat gland carcinoma and oncocytomas. However, endocrine mucin-producing sweat gland carcinoma is excluded by the presence of goblet cells, the uniform oxyphilic cytoplasm of the epithelial cells, and the negative immunohistochemical staining for neuron-specific enolase, chromogranin, synaptophysin, estrogen receptor, and progesterone receptor. Complete surgical excision is the treatment of choice for oncocytomas. This case highlights the clinical and histopathological presentation of ocular oncocytomas and raises awareness of this rare entity for both the practicing dermatologist and dermatopathologist.

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Caruncular Oncocytoma Mimicking Malignant Melanoma

Cited by 5 publications

References 22 publications

Clinico-pathological correlation of lacrimal caruncle tumors: a retrospective analysis over 22 years at the University Eye Hospital Bonn

Clinico-pathological correlation of lacrimal caruncle tumors: a retrospective analysis over 22 years at the University Eye Hospital Bonn

Oncocytic lesions of the ocular adnexa

Unusual Case of a Caruncular Oncocytoma

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