Background: Basal cell carcinoma (BCC) is caused by carcinogenic transformation of epithelial basal cells and hair follicle cells. The most common site of BCC onset in the eye is the skin around the eyelids, and the onset from caruncle is extremely rare. Furthermore, intraorbital invasion of BCC rarely occurs in the caruncle. We report two cases of BCC occurring in the caruncle.
Cases: Case 1 is a 76-year-old woman who experienced a foreign body sensation in the inner canthus of her left eye. She was diagnosed with conjunctival tumor, and was referred to our hospital. A dark brown mass with clear borders and prominent vascularity was observed in the caruncle of the left eye. BCC was diagnosed based on the results of an excisional biopsy, and the patient did not show recurrence since then.
Case 2 is a 52-year-old male who was referred to our hospital because of a dark red mass in the inner canthus of his left eye, which caused lacrimation and pain. BCC diagnosis was established based on the results of an incisional biopsy performed on the caruncle mass. The mass and the surrounding tissue were percutaneously excised in timely fashion because subsequent imaging and lacrimal duct endoscopy revealed involvement of the upper lacrimal canaliculus and intraorbital invasion. The patient has been undergoing conservative follow-up, and no definitive recurrence has been observed since then.
Conclusion: BCC may occur in the caruncle and invade the orbit; however, such cases are extremely rare.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 45-49, 2024.