Lesions of the lacrimal caruncle. Clinicopathologic features

The rarity of lesions of the lacrimal caruncle, in addition to their wide variety of histopathologic types, makes an accurate clinical diagnosis difficult. To comprehensively illustrate the clinical and histopathologic features of these lesions, the authors conducted a retrospective analysis of all caruncular lesions that underwent biopsy at a large referral ophthalmologic hospital during a 33-year period.

The files of the Laboratory of Pathologic Anatomy from July 1957 through July 1990 were reviewed. The slides of 113 cases were reviewed and classified in two main categories: (1) inflammatory lesions and (2) neoplasms and pseudoneoplasms. The age and sex of the patient as well as preoperative clinical diagnosis were analyzed.

Among the 113 patients whose surgical specimens were evaluated, there were 44 males and 69 females. The mean age was 31 years. The clinical diagnosis was accurate in only 50% of the patients. The authors found 16 different histopathologic types of lesions. Nevi accounted for 34% and papillomas for 26% of the total analyzed lesions. Only 5.3% of the lesions were found to be malignant.

In this series, the authors confirm the low frequency of caruncular lesions, as well as their wide variety of histopathologic types. The authors found a wide range of ages and a slight female predominance. Nevi and papillomas were the most frequent lesions, and clinically they were properly diagnosed in most of the cases. Although malignancy was uncommon, it was suspected in only half of the cases.