ArticleFrontiers in ophthalmology2026
Subepithelial nevus and papilloma of the lacrimal caruncle: a case report and literature review.
Article in Frontiers in ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Lacrimal caruncular tumors are rare and exhibit a diversity of possible histopathological types. The majority of caruncular tumors are benign, followed by premalignant and malignant lesions, which are associated with a poorer prognosis. Clinical diagnosis is challenging. Therefore, a tissue biopsy is considered and performed based on the presence of features suggesting malignant or undetermined tumors for a definite diagnosis and proper management. The coexistence of different types of benign caruncular tumors is extremely rare and has been rarely described. Case presentation: We herein describe the case of a 63-year-old Thai woman with a history of chronic progressive painless visual loss in her right eye who reported a non-progressive painless hyperpigmented mass without a history of associated contact bleeding on her left lacrimal caruncle. Ophthalmic examination revealed a large hyperpigmented choroidal mass with adjacent exudative retinal detachment in her right eye and a papilliform pinkish lesion over a well-defined, homogeneous, hyperpigmented mass on her left caruncle. Magnetic resonance imaging (MRI) scans of the orbit indicated a malignant choroidal melanoma in her right eye. The regional and distant metastatic work-ups were unremarkable. The patient was treated with a right globe enucleation concurrent with complete tumor removal of the left caruncular mass based on the presence of intratumorally dilated vessels with a feeding vessel to the overlying papilliform lesion, raising suspicion of malignancy, using the no-touch technique, followed by double freeze-thaw cryotherapy. Histopathological examination disclosed a choroidal melanoma in the right eye and a subepithelial caruncular nevus with an overlying conjunctival papilloma emerging from the conjunctival epithelium of the nevus in the left eye. The patient made a complete recovery with no evidence of recurrence at the 12-month follow-up. Conclusion: Coexistence of benign caruncular tumors is extremely rare. We report a rare case of a subepithelial nevus combined with a papilloma at the lacrimal caruncle. Complete tumor resection using the no-touch technique is the primary treatment. Adjunctive double freeze-thaw cryotherapy may be considered to further prevent tumor cell seeding and postoperative recurrences.
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