Ahmed H Shafeeq, Nair Samyuktha Vinu, Sache Mohammed Sulaiman, Das Rishika, Gupta Aryan, Choradia Sakshi C, Prakash Likitha, Praveen Priyamvada Bangre, Gowda Prajwal, Gupta Sneha, Bharath C H Sai, Shivananda Deepak B, Thrishulamurthy Chinmayee J
Department of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, India.
Eye (Lond). 2025 Feb;39(3):424-435. doi: 10.1038/s41433-024-03560-w. Epub 2024 Dec 23.
The lacrimal caruncle, a nodular structure located at the inner canthus, contains a variety of tissue types, leading to diverse clinical manifestations of its lesions. Caruncular lesions, though rare, may be benign or malignant, complicating diagnosis and treatment. This systematic review aims to provide a comprehensive overview of the clinical profiles, histopathological features, and management strategies for caruncular lesions.
This was a PROSPERO-registered (CRD42024529956), PRISMA guideline-adherent systematic review. Databases searched include PubMed, Scopus, and CINAHL Ultimate from inception to June 29, 2024. Grey literature was also searched. Studies involving patients diagnosed with caruncular lesions were included. A novel classification strategy has been developed and proposed.
From an initial 1602 articles, 16 studies were included, representing a range of demographics and clinical features. Histopathological diagnosis varied widely, with benign lesions more common than malignant ones. Common benign lesions included nevi, papillomas, and pyogenic granulomas, while malignant lesions included basal cell carcinomas, sebaceous cell carcinomas, and melanomas. Medical management often combined topical therapies with surgical excision. Surgical management primarily involved excision, with some cases necessitating more radical procedures, which were typically reserved for extensive or malignant lesions. Recurrence was noted in several studies, with melanomas being at the highest risk of recurrence.
Caruncular lesions exhibit diverse histopathological profiles, necessitating a combination of clinical and histopathological examination for accurate diagnosis and management. Early detection and appropriate management are crucial for improving patient outcomes. Despite the rarity of these lesions, their potential malignancy and systemic metastasis create a need for prospective studies.
泪阜是位于内眦的结节状结构，包含多种组织类型，导致其病变有多种临床表现。泪阜病变虽罕见，但可能是良性或恶性的，使诊断和治疗复杂化。本系统评价旨在全面概述泪阜病变的临床特征、组织病理学特征及管理策略。
这是一项在PROSPERO注册（CRD42024529956）、遵循PRISMA指南的系统评价。检索的数据库包括自创建至2024年6月29日的PubMed、Scopus和CINAHL Ultimate。还检索了灰色文献。纳入涉及诊断为泪阜病变患者的研究。已开发并提出了一种新的分类策略。
从最初的1602篇文章中，纳入了16项研究，涵盖了一系列人口统计学和临床特征。组织病理学诊断差异很大，良性病变比恶性病变更常见。常见的良性病变包括痣、乳头状瘤和化脓性肉芽肿，而恶性病变包括基底细胞癌、皮脂腺癌和黑色素瘤。药物治疗通常将局部治疗与手术切除相结合。手术治疗主要涉及切除，一些病例需要更根治性的手术，通常用于广泛或恶性病变。几项研究中提到了复发情况，黑色素瘤复发风险最高。
泪阜病变表现出多样的组织病理学特征，需要结合临床和组织病理学检查进行准确诊断和管理。早期发现和适当管理对于改善患者预后至关重要。尽管这些病变罕见，但其潜在的恶性和全身转移需要进行前瞻性研究。
