Caruncular Tumor as the First Sign of T-Cell Lymphoma Relapse

Abstract

The lacrimal caruncle is a modified cutaneous tissue that contains hair follicles, accessory lacrimal glands, sweat glands, lobules of fat, and sebaceous glands. Due to the nature of tissue, a variety of lesions, both benign and malignant, could arise from this area. Lymphomas of the eye and its adnexa are frequently of B-cell lineage. We would like to report a rare and unique case of a patient presenting with a caruncular tumor of CD30-positive T-cell anaplastic large cell lymphoma (T-ALCL) origin, serving as the first, initial, sole sign of recurrence of previously treated cutaneous T-ALCL. We believe this to be the first such report in the literature. We aim to emphasize the importance of considering such a condition while formulating the differential diagnosis of caruncular tumour in patients with history of T-cell lymphoma and to characterize the clinical course of such a presentation.

Malignant lymphoma of the conjunctiva

“…16,71 Age more than 50 years is prognostic for T-cell lymphomas, as these patients are 3 times more likely to have progression or recurrence of the disease. 41,69,137 Furthermore, it seems that for conjunctival T-cell lymphomas, nonbulbar location (including the caruncle or plica semilunaris and the limbus) confers a worse prognosis. 17,76,145 Finally, it is important to mention that, although conjunctival lymphoma appears to have a good prognosis, long-term follow-up is necessary because the risk of mortality continues to exist after many years.…”

Clinico-pathological correlation of lacrimal caruncle tumors: a retrospective analysis over 22 years at the University Eye Hospital Bonn

“…Malignant neoplasias at the caruncle comprise basal cell carcinoma, squamous cell carcinoma, basosquamous carcinoma, malignant melanoma, lymphoma, and sebaceous gland carcinoma [ 5 – 9 , 15 , 17 – 20 ]. Rare malignant lesions include Kaposi sarcoma [ 8 , 11 ], rhabdomyosarcoma [ 21 ], plasmacytoma [ 4 , 7 ], metastatic lung carcinoma [ 22 ], mucoepidermoid carcinoma [ 23 ], and relapse of T cell lymphoma [ 24 ].…”

“…Patients with caruncular lymphoma were typically older than RLH patients [ 1 – 3 ]. Regarding lymphoma as main differential diagnosis, there is a report of a relapse of a T cell lymphoma manifesting at the caruncle [ 24 ].…”