Outcomes and imaging features of oncocytic lesions

The authors of this retrospective study sought to describe the clinical, imaging and pathology features of oncocytic lesions in the ocular adnexa. They conducted this study because while there is a wealth of information on histopathologic features and clinicopathologic correlations of oncocytic lesions, there is a relative paucity of published information on clinical data, imaging features and treatment outcomes, primarily because the majority of case series emanate from pathology laboratories with limited information on clinical features.

They analyzed their experience with 15 oncocytic lesions of the ocular adnex – 14 oncocytomas and 1 oncocytic hyperplasia – and reviewed 197 cases from the literature.

The mean age of the patients was 66 years. Lesions were typically well-circumscribed, painless masses involving the caruncle that were present a mean of six months prior to diagnosis. Lesions had a mean basal diameter of 4.1 mm, were typically dark blue and had cystic features confirmed by ultrasound biomicroscopy and optical coherence tomography. Histopathology showed columnar cells with abundant eosinophilic cytoplasm in the lining epithelium and in some cases cystadenomatous hyperplasia.

Complete surgical excision was curative without recurrence after a mean follow-up of 39 months. Epithelial cells with copious quantities of intensely eosinophilic cytoplasm characterize the oncocytic transformation histopathologically.