Caruncular Oncocytoma in an Elderly Pakistani Female: A Case Report

Abstract

Caruncular Oncocytoma (CO) is a benign epithelial tumor, frequent in elderly females. Caruncular lesions are rare compared to conjunctival lesions, with a reported incidence of 0.3 to 1.1 %, and histologically proven oncocytoma are 0.3 million/year. The mitochondrial and somatic gene mutations, resulting in defective oxidative phosphorylation, are responsible for oncocytoma. This reduces ATP, resulting in a decrease in energy production, which, in compensation, increases mitochondrial content. The common complaint is epiphora, which is excessive lacrimation. CO is composed of oncocytes with fine, eosinophilic cytoplasm containing numerous mitochondria. A 60-year-old lady presented in an Ophthalmology outdoor clinic with a small, nodular, painless, reddish-colored swelling at the inner canthus of the left eye for three years. No clinical complaints and visual disability were noted. On physical examination, a mass with overlying, reddish-colored mucosa was located at the medial canthus of the left eye. Excision in Toto was done. Grossly, there was a 10 mm × 5 mm × 5 mm smooth surfaced, red-colored mass with round contours. Microscopy showed a wellencapsulated mass with overlying thinned-out stratified squamous epithelium and sebaceous glands. The underlying lesion is composed of tall, columnar, uniform cells with round to oval nuclei, fine chromatin, and abundant granular cytoplasm.

Keywords

• caruncle
• oncocytoma
• mitochondria.