Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug 18;85(2):174-177.
doi: 10.5935/0004-2749.20220023. eCollection 2021.

Sebaceous adenoma of the conjunctiva and caruncle: a clinicopathological report of three cases and literature review

Mariana Borges Barcellos Dias  1 , Melina Correia Morales  1 , Arthur Gustavo Fernandes  1 , Moacyr Rigueiro  2 , Alexandre Nakao Odashiro  3 , Rubens Mattos Belfort Neto  1
Affiliations
Review

Sebaceous adenoma of the conjunctiva and caruncle: a clinicopathological report of three cases and literature review

Mariana Borges Barcellos Dias et al. Arq Bras Oftalmol. .

Abstract
in English, Portuguese

Sebaceous tumors of the conjunctiva and caruncle are rare conditions, accounting for 1% of caruncle lesions and even lower among conjunctival lesions. Almost 50% of cases are associated with Muir-Torre syndrome, a rare autosomal-dominant condition characterized by at least one sebaceous skin tumor and one visceral malignancy. We report 3 cases of sebaceous adenoma with different presentations that were submitted to excisional biopsy and immunohistochemical study. Diagnosis of these tumors should increase the level of suspicion and lead to clinical investigation to rule out neoplasms, particularly because in up to 41% of cases, these can be the first sign of the disease.

Tumores sebáceos da conjuntiva e carúncula são condições raras, sendo mais encontrados nas pálpebras. O adenoma sebáceo é responsável por 1% das lesões carunculares e ainda menos frequente nas lesões da conjuntiva. Esse diagnóstico é de suma importância pois quase 50% desses pacientes podem ser diagnosticados com a Síndrome de Muir-Torre, uma condição autossômica dominante rara que é caracterizada pela presença de ao menos um tumor de pele sebáceo e uma neoplasia visceral (gastrointestinal, câncer geniturinário e de mama). O estudo tem como objetivo relatar 3 casos de adenoma sebáceo com diferentes apresentações, que foram submetidos a biópsia excisional e estudo imuno-histoquímico. O diagnóstico desses tumores deve levantar suspeitas e aconselhar a investigação clínica para descartar outras neoplasias, principalmente porque em até 41% dos casos esse pode ser o primeiro sinal da Síndrome de Muir-Torre.

PubMed Disclaimer

Conflict of interest statement

Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
(A) Biomicroscopic examination image showing a yellowish conjunctival lesion, with a papillomatous aspect on plica semilunaris topography. (B) Higher magnification.
Figure 2
Figure 2
(A and B) Histopathological examination results showing a nodular and lobulated tumor (hematoxylin-eosin [H&E], staining, original magnifications ×40 and ×100). (C) At the center, the tumor is composed of mature sebocytes with a clear cytoplasm containing lipid vacuoles without atypia. The periphery of the lobules consisted of small darker cells represented by basaloid germinative cells (H&E, original magnification ×200). (D) Immunohistochemistry with Ki67, a cell proliferation marker, is mainly negative in well-differentiated sebaceous cells and positive at the periphery of the lobules in germinative cells. This is consistent with the diagnosis of sebaceous adenoma (SA).
Figure 3
Figure 3
Immunohistochemistry of the mismatch repair proteins MSH6, PMS2, MHL1, and MSH2 showing nuclear positivity in the cells with all four markers.
Figure 4
Figure 4
(A) Clinical appearance of a papillomatous caruncle nodule. (B) Low-power view showing a lobulated tumor composed of clear cells on the center and darker cells at the periphery of the lobules (hematoxylin-eosin staining [H&E], original magnification ×40). (C) The tumor is composed of mature sebocytes with clear cytoplasms without pleomorphism or brisk mitotic activity. At a higher magnification, the cells present round-to-oval nuclei with well-distributed chromatin, conspicuous nucleoli, and a vacuolated clear cytoplasm (H&E, original magnification ×400). (D) Yellowish subepithelial mass suggestive of sebaceous adenoma. (E) Histopathological examination result showing a well-delimitated and lobulated tumor, with features identical to those of cases 1 and 2 (H&E, original magnification ×40). (F) The clear cytoplasm represents empty spaces filled by the lipid vacuoles that were artefactually dissolved during specimen processing (H&E, original magnification ×400).
See this image and copyright information in PMC

References

    1. Kaeser PF, Uffer S, Zografos L, Hamédani M. Tumors of the caruncle: a clinicopathologic correlation. Am J Ophthalmol. 2006;142(3):448–455. - PubMed
    1. Ilhan HD, Turkoglu EB, Bilgin AB, Bassorgun I, Dogan ME, Unal M. A unique case of isolated sebaceous adenoma of the bulbar conjunctiva. Arq Bras Oftalmol. 2016;79(4):253–254. - PubMed
    1. Tok L, Tok OY, Argun M, Ciris IM, Baspinar S, Gunes A. Corneal limbal sebaceous adenoma. Cornea. 2014;33(4):425–427. - PubMed
    1. Cohen PR, Kohn SR, Kurzrock R. Association of sebaceous gland tumors and internal malignancy: the Muir-Torre syndrome. Am J Med. 1991;90(5):606–613. - PubMed
    1. Luthra CL, Doxanas MT, Green WR. Lesions of the caruncle: a clinicohistopathologic study. Surv Ophthalmol. 1978;23(3):183–195. - PubMed

LinkOut - more resources