RESEARCH > Case Studies

Eye Cancer Network Case #7: Periocular Hydrocystoma

A variably pigmented tumor of the caruncle was noted to grow over a 6-month period. Note the hyper-vascularity over the apex and subconjunctival pigment deposits (arrows).

History: A 71 year-old male presents with a variably pigmented and growing caruncular tumor. Subconjunctival melanocytic cysts were noted (arrows).

Clinical Impression: Hidrocystoma of the Caruncle

*Note* Due to progressive growth, hypervascularity, and subconjunctival pigmentation, this tumor was treated by excisional biopsy.

Comment: In this case hidrocystoma of the caruncle was suspected by clinical examination. High frequency ultrasound supported this diagnosis. Due to the presence of subconjunctival pigmentation and history of growth, an excisional biopsy was requested and performed. This case demonstrates the utility of high frequency ultrasound in the evaluation of the caruncle.

High-frequency ultrasound demonstrates a 2.7 mm cystic elevation containing a moderately reflective, egg-shaped mass (arrow).  One basal dimension was measured to be 3.2 mm and its edges induced orbital micro-shadows (arrow). Proliferative simple cyst of eccrine or apocrine origin, clinically at the caruncle (common sites include the lid margin and caruncle). Hematoxylin and Eosin x 10 Hemosiderin and Melanin can accumulate within the cyst. The cyst contents typically affect its coloration. Hematoxylin and Eosin x 40

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