Sebaceous carcinoma of lacrimal caruncle in a Chinese patient

To describe a case of sebaceous carcinoma of the caruncle and review relevant literature to raise awareness about this rare disease.

A 63-year-old Chinese man presented with a nontender mass that had developed within the right lacrimal caruncle more than 3 years previously and had been growing in size. The patient was admitted to the hospital, and no systemic diseases were noted on physical and instrumental examinations. The mass was removed intact, and 10 small map biopsies of the surrounding conjunctiva and deeper tissues were performed. Thereafter, 0.04% mitomycin C was applied to the surgical defect for 5 minutes before repair by conjunctival autografting. The gross specimen was observed to be firm and yellow. Microscopic examination revealed that the tumor consisted of lobules, composed of pleomorphic vacuolated cells with central necrosis. The pathologic diagnosis was a well-differentiated sebaceous cell carcinoma of the caruncle that did not extend to the deep surgical margins. Moreover, no tumor recurrence was noted 12 months after surgery.

The occurrence of sebaceous cell carcinoma in the caruncle is rare. In general, this neoplasm is often both clinically and histopathologically misdiagnosed as a benign condition, resulting in both a delay in correct diagnosis and increased morbidity and mortality. Therefore, this malignancy should be considered in the differential diagnosis of caruncular lesions. The suspected neoplasm should be removed by margins that are as wide as possible; map biopsies are considered to be useful to rule out the subclinical spread of the tumor.