Case #7: Periocular Hydrocystoma

By Paul T. Finger, MD

History

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).
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).

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.

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