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Photo Essay
February 2004

Neurofibroma Involving the Caruncle

Arch Ophthalmol. 2004;122(2):294-295. doi:10.1001/archopht.122.2.294

A 48-year-old woman with a history of neurofibromatosis was referredfor evaluation of a slow-growing mass involving her left eye. The mass hadbeen present for at least 2 years. There was no history of any ocular surgery.On examination, a pedunculated mass with a diameter of approximately 3 mmwas noted in the region of the left caruncle (Figure 1). Findings from magnetic resonance imaging of the brainand orbits were negative and did not demonstrate any tumors in the orbit,including the optic nerve. The patient underwent an excisional biopsy of thecaruncular lesion, and it was sent for pathologic examination. Sections revealeda well-delimited neoplasm composed of cells with spindle-shaped nuclei witha fibrillar background (Figure 2).The tumor cells were positive for S100 protein (Figure 3). The presence of this protein was consistent with a tumorof Schwann cell origin. The presence of neurites in the tumor substance andthe absence of a tumor capsule indicated that the tumor was a neurofibroma(Figure 4). No evidence of dysplasiaor malignancy was noted within the tumor or the overlying epithelium.

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