Sebaceous gland hyperplasia of the caruncle

The caruncle is an ocular adnexal structure composed of both mucosal and epidermal elements. Consequently, a number of benign and malignant lesions of epithelial and supportive tissues may arise in this area. Lesions of the caruncle are rarely reported, and their appropriate diagnosis and management may be uncertain. One such lesion is sebaceous gland hyperplasia. Of all caruncular lesions that undergo excision, sebaceous gland hyperplasia is infrequently encountered. We have observed four cases of sebaceous gland hyperplasia of the caruncle over the last 2 years. Our observations suggest that this lesion has a characteristic onset, progression, and appearance, enabling diagnosis to be made on clinical examination alone. Excision is indicated only if there is an atypical presentation, a carcinoma is suspected, if mass effect causes discomfort or epiphora, or if cosmesis is an issue.