A 63-year-old Thai woman had a pigmented left lacrimal-caruncle lesion that histology identified as a subepithelial nevus with overlying conjunctival papilloma, while the right eye had choroidal melanoma. After no-touch caruncular excision plus cryotherapy, no recurrence was seen at 12 months.
Key findings
- Histology confirmed right choroidal melanoma and a benign left subepithelial caruncular nevus with overlying conjunctival papilloma. Recovery was complete without recurrence during follow-up, but the contribution of cryotherapy cannot be separated from complete excision.
Why this matters globally
The rarity makes the case useful for ophthalmic differential diagnosis and reinforces histopathological assessment when pigmented or vascular caruncular lesions appear malignant.
Thai researcher contribution
All five authors are from ophthalmology and pathology at the Faculty of Medicine Ramathibodi Hospital, Mahidol University, covering clinical care and tissue diagnosis.
Limitations to consider
One case cannot estimate prevalence, risk factors or comparative treatment effectiveness. Twelve months may miss later recurrence, and contralateral melanoma does not establish a biological link to the benign caruncular tumors.