Ocular adnexal oncocytoma: a case series and clinicopathologic review of the literature.

The authors report the clinical, microscopic, and ultrastructural features of four oncocytic lesions involving the ocular adnexa. Three of the lesions originated in the ocular caruncle of elderly women, and a single case was encountered from the medial eyelid of an elderly man. Each lesion clinically presented as a slow-growing, painless, red mass. The histopathologic features were distinctive, with polyhedral cells containing granular eosinophilic cytoplasm found to consist of large numbers of mitochondria on ultrastructural examination. Of the 40 cases previously reported primarily in the ophthalmologic literature, the cases reported here similarly involved the eyelid and associated ocular adnexa with a predilection for elderly women. Oncocytomas probably represent an age-associated metaplastic and neoplastic transformation of the glandular epithelium comprising the ducts of salivary glands.