Atlas of Ophthalmology

Melanocytic Nevus of the Caruncle (Follow-up 15 Months)

Conjunctiva -> Tumor, Neoplasma -> Benign
Patient: 30 years of age, female, BCVA 1.0. General Medical History: empty. Ocular Medical History: Patient noticed dark lesion. Main Complaint: none. Methods: Colour Photography, follow up 15 months. Findings: 02/2012: The nevus clinically appears as a brown pigmented lesion, presumedly composed of epithelial and subepithelial nests of benign melanocytic cells. 05/2013: No changes in its appearance were noticed. Discussion: The caruncle is a nodular structure lying at the internal canthus, medial to the plica semilunaris. The caruncle is widely exposed in the palpebral aperture. Patients or physicians easily notice changes in its appearance. It was reported the types and incidence of caruncular lesions (1) of a total of 195 consecutive caruncular lesions from 191 patients. The most common type were nevi (47%) and papillomas (15%). They found that 94% were benign, 3% were premalignant, and 2.6% were malignant. It was concluded, that malignancy is clinically overestimated, and some malignant lesions can take a benign aspect, justifying close photographic follow-up of all lesions. Because caruncular malignant melanoma is associated with poor prognosis, pigmented lesions should be monitored carefully. In the absence of clear criteria for malignancy, any change in color, size, or vascularization of a caruncular lesion should hasten excision. Literature: (1) Kaeser PF, Uffer S, Zografos L, Hamédani M. Tumors of the caruncle: a clinicopathologic correlation. Am J Ophthalmol. 2006 Sep;142(3):448-55.

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