Research

Atypical Sebaceous Adenoma of the Caruncle

AAO Journal5d ago1 min read

A 68-year-old man presented with a mass at the right canthus for >30 years. Examination revealed a yellowish-white, firm, mobile tumor on the right caruncle, with defined borders. The surface was irregular with abundant blood supply (A). Pathological and immunohistochemical examination confirmed a sebaceous adenoma of the caruncle. Hematoxylin-eosin staining revealed polygonal tumor cells arranged in nests. Central tumor cells displayed foamy cytoplasm (asterisks), with well-defined sebaceous lobules of varying sizes and shapes (B).

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AI Summary

Quick Take

A 68-year-old male presented with a long-standing, 30-year-old firm mass on the right caruncle that was histologically confirmed as a sebaceous adenoma. The yellowish-white, mobile tumor featured an irregular surface and abundant blood supply, highlighting the caruncle as a rare but significant site for these benign sebaceous neoplasms.

Why It Matters

While the caruncle contains various glandular tissues, sebaceous adenomas in this location are rare and can easily be mistaken for more common lesions like papillomas or more aggressive sebaceous carcinomas. The 30-year history in this case illustrates the slow-growing nature of these tumors, but their presence should always trigger a high level of clinical suspicion. Crucially, sebaceous adenomas are known cutaneous markers for Muir-Torre syndrome; identifying such a lesion necessitates a deeper dive into the patient's systemic health and family history of internal malignancies.

Key Findings

The patient presented with a slow-growing, firm, mobile mass on the right caruncle that had been present for over 30 years.
Clinical examination revealed a yellowish-white tumor with defined borders, an irregular surface, and a prominent blood supply.
Histopathological analysis using hematoxylin-eosin staining showed polygonal tumor cells arranged in distinct nests.
Microscopic features included central tumor cells with characteristic foamy cytoplasm and well-defined sebaceous lobules of varying sizes and shapes.
Diagnosis was confirmed through both pathological and immunohistochemical examination.

Study Snapshot

Design

Case Report

Population

68-year-old male

Sample Size

Practice Implications

Clinicians should consider sebaceous adenoma in the differential diagnosis of any yellowish caruncular mass, even those with long-term stability. Given the potential association with Muir-Torre syndrome, a confirmed diagnosis should prompt a referral for systemic screening or a detailed review of the patient's history regarding gastrointestinal or genitourinary cancers.

Who's Affected

Oculoplastic SurgeonsComprehensive OphthalmologistsOptometristsOcular Pathologists

Evidence StrengthPreliminary

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