Bilateral nevus of the caruncle

BACKGROUND: Pathologic processes of the caruncle are relatively rare with a predominance of papillomas, pyogenic granulomas and nevi. PATIENT: A 22 year old Caucasian male patient presented with bilateral hyperpigmentations of the caruncle. They had first been observed at an age of seven and showed slight progression in size and colour with time. Examination revealed hyperpigmentation with clear pseudocystic spaces. The tarsal or bulbar conjunctiva was not involved. An excision of both processes was performed. HISTOLOGY: Light microscopy revealed nests of nevus cells with melanin granules and round basophilic nuclei as well as gland ducts and sebaceous glands, beneath and within the multilayered keratinizing and nonkeratinizing squamous epithelium. The sections revealed a bilateral melanocytic compound nevus of the caruncle. DISCUSSION: To our knowledge, there is no report on bilateral nevi of the caruncle among the Caucasian population. The possibility of a common precursor cell during the embryologic development causing the bilaterality is discussed.