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Abstract

Oncocytomas are benign tumors arising from epithelial cells that are typically slow growing, well circumscribed, and composed of oncocytes containing eosinophilic cytoplasm densely filled with mitochondria. Though typically found in the kidneys, salivary glands, or the thyroid gland, oncocytomas are also a rare tumor in the ocular region. Literature review showed ocular oncocytomas are more frequently found in the caruncle, lacrimal sac, and conjunctiva and less frequently found in the lacrimal gland, eyelid, and eyelid margin. Ocular oncocytomas present clinically as a painless slow growing cystic or solid pink-red lesion. Treatment of choice is surgical excision. Lesions can be divided into one of three of histological architectural patterns; papillary-cystic pattern with prominent epithelial tufts, tubular-pseudoacinar pattern with tubules lined by tall columnar epithelium, or solid-trabecular pattern with cuboidal or polygonal cells in a trabecular arrangement. We present the pathology of three periocular oncocytomas sent to our dermatopathology department. Specimen A, biopsied from the left caruncle/conjunctiva of a 85-year-old female, showed large round epithelial cells with granular cytoplasm forming ducts and cystic structure filled with eosinophilic material. Specimen B, biopsied from the left caruncle of a 64-year-old male, showed a well-circumscribed dermal based proliferation of polyhedral cells with eosinophilic granular cytoplasm forming glands. Specimen C, biopsied from the left eyelid/conjunctiva of a 71-year-old male, showed dilated tubules lined with epithelial cells containing granular eosinophilic cytoplasm interspersed by occasional goblet cells. This series highlights a rare tumor a dermatopathologist may encounter on periocular specimens biopsied by dermatologists and ophthalmologists.