"Strawberry-like" Mass in the Lacrimal Caruncle: Squamous Cell Carcinoma in Situ

We report a rare case of squamous cell carcinoma in situ (SCCIS) of the lacrimal caruncle in a 90-year-old male presenting with a strawberry-like mass. The lesion, unnoticed for 3 months, was surgically excised with tumor-free margins. Histopathological analysis confirmed full-thickness epithelial atypia without stromal invasion, consistent with SCCIS. Immunohistochemistry showed strong p16 expression and HPV positivity. No recurrence was observed at 6-month follow-up. Although SCCIS in the caruncle has been rarely documented, its distinct clinical appearance may facilitate early recognition. This case underscores the importance of considering malignancy in elderly patients with atypical caruncular lesions, as prompt surgical intervention can lead to favorable outcomes.