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Published on: January 7, 2019
Caruncular lesions: A 16-year single centre review in the United Kingdom
Camille Yvon1, Thiagarajah Balamurugan1, Eleonora Bianchi1
1Royal Surrey County Hospital, Guildford, UK.
Insights
This study reviewed caruncle biopsies in the UK, finding a variety of lesions including a notable proportion of malignant melanomas. Excisional biopsies are recommended to rule out malignancy in caruncular lesions.
Area of Science:
- Ophthalmology
- Dermatopathology
- Histopathology
Background:
- Caruncular lesions are uncommon and present a diagnostic challenge.
- This study reviews clinicopathological features of caruncle biopsies from a UK district general hospital.
- It compares findings with previously published data from other centers.
Purpose of the Study:
- To review the clinicopathological features of caruncle biopsies.
- To compare UK findings with international data.
- To assess the diagnostic accuracy of pre-operative assessments.
Main Methods:
- Retrospective, single-centre, observational case series.
- Analysis of 31 caruncular lesions from 31 patients between 2004-2020.
- Histopathological classification of identified lesions.
Main Results:
- A diverse range of 13 histopathological types were identified.
- Melanocytic nevi (29%) and benign squamous papillomas (23%) were most common.
- Malignant melanomas accounted for 6% of lesions, with pre-operative diagnosis correct in 67% of available cases.
Conclusions:
- The variety of caruncular lesions complicates diagnosis.
- This UK-based series shows a slightly higher proportion of malignant melanomas.
- Excisional biopsies are advised for most caruncular lesions to exclude malignancy.
Background/Aims:
To review the clinicopathological features of caruncle biopsies carried out at a district general hospital in the United Kingdom (UK), and compare with other centres where data has been published.
Methods:
Retrospective, single-centre, observational case series between 2004-2020.
Results:
A total of 31 lesions from 31 patients were analysed. 18 of 31 patients were men (58%), and the age ranged from 12 to 91 years. 13 different histopathological types of lesions were identified in our case series, including 9 melanocytic nevi (29%), 7 benign squamous papillomas (23%), 5 skin adnexal lesions (16%), 3 chronic inflammation (10%), 3 epithelial cysts (10%), 1 basal cell carcinoma (3%), 2 malignant melanomas (6%) and l lymphoproliferative disorder (3%). Pre-operative suspected diagnoses were often vague but correct in 12 of 18 cases (67%), where data was available.
Conclusion:
The uncommon nature and variety of caruncular lesions make the diagnostic process difficult. Our case series is the first reported in the UK, showing a slightly higher proportion of malignant melanomas, in keeping with the population demographics. Excisional biopsies would, therefore, be prudent in the majority of cases to rule out any possible malignancy.
