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Oncocytoma of the Caruncle

An elderly woman was seen with a red vascularized mass present on the caruncle of her right eye. The mass was excised because of its unusual appearance and because it was growing. Pathologic examination showed it was an oncocytoma, a tumor composed of unusual swollen epithelial cells. These masses may occur in the caruncle, the lacrimal sac, or the lacrimal gland of older patients, and may be malignant, although they are usually benign. Oncocytomas of the caruncle often are diagnosed clinically as hemangiomata or nevi. They are familiar sights to the pathologist, but not to the practicing ophthalmologist. However, only by being familiar with its characteristics will the clinician be able to diagnose an oncocytoma.