PMC5927183_01
Clinical appearance of the tumor of the lacrimal caruncle at the first visit.. Notes: (A) Outside of the tumor. It appeared smooth surface and was whitish with dilated capillaries. In addition, the apical portion of the tumor had a papilloma-like appearance with mild hyperemia (*). (B) Backside of the tumor. The "navel-like structure" was observed near the center of the lesion in the backside (arrow).
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Its base had a smooth surface and was whitish with dilated capillaries (Figure 1A). After inverting the protruding portion of the tumor, which appeared to be growing from the palpebral fissure, with a cotton swab, a "navel-like structure" was observed near the center of the lesion (Figure 1B).
Histopathological findings on staining with H&E.. Notes: (A) Appearance of the papilloma and sebaceous gland hyperplasia regions. The apical portion of the tumor resembled a conjunctival papilloma and papillary proliferation of the epithelium was seen (*). At the base of the tumor, sebaceous gland hyperplasia was observed. Bar=1 mm. (B) High-magnification image of the sebaceous gland hyperplasia region. The sebaceous gland hyperplasia was observed involving adipocytes with moderate inflammatory cell infiltration ( ). Bar=400 microm.
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The resected tumor was subjected to histopathological examination after staining with H&E (Figure 2).
Result of the in situ hybridization for HPV positivity.. Notes: HPV-51 was detected in the apical portion (triangle). IS: Aminolevulinate deltasynthase 1 was amplified for the multiplex PCR. ES for multiplex PCR: DNA fragments derived from Brevundimonas diminuta cloned to plasmid pCRII-TOPO (Invitrogen Corporation, Carlsbad, CA, USA) were added to the PCR mixtures along with external plasmid-specific primers. HPV-35 was negligible (*).. Abbreviations: ES, external positive standard; HPV, human papillomavirus; IS, internal positive standard..
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The apical portion of the tumor with papilloma-like features was subjected to in situ hybridization using an HPV DNA probe.9 The assay targeted HPV types -6, -11, -16, -18, -30, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, and -66, among which only HPV-51 was detected (Figure 3).
Clinical appearance after resection of the tumor.. Notes: There has been no recurrence of the tumor up to 3 years postoperatively.
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