Peripunctal Mass Lesions: Clinicopathological Analysis and Surgical Outcomes-A Multicentric Series

Ophthalmic Plast Reconstr Surg. 2022 Mar-Apr;38(2):154-159. doi: 10.1097/IOP.0000000000002012.


Purpose: To report the epidemiology, histopathological spectrum, and surgical outcomes of peripunctal mass lesions.

Methods: Multicentric retrospective case series involving 6 centers in India. All cases of peripunctal masses with histopathological diagnoses and minimum follow up of 3 months were included. Demographic data, clinical photographs, objective assessments of clinical improvement were assessed before and after treatment.

Results: A total of 50 patients were included. The mean age was 46.4 years (range: 12-76 years). The mean duration of complaints was 27.4 months (range: 1-120 months) and mean follow-up period after surgery was 15.8 months (range: 3-120 months). The most common presenting complaints were a mass lesion/cosmetic concern (82%), followed by epiphora (48%) and foreign body sensation (16%). The most common lesion was melanocytic nevus (19/50; 38%), followed by squamous papilloma (8/50; 16%), hidrocystoma (7/50; 14%), and epidermoid cyst (7/50; 14%). Three cases of malignant tumors were diagnosed: 2 cases of sebaceous gland carcinoma and 1 case of squamous cell carcinoma. In all, 21 of 50 (42%) cases underwent excision with the placement of a Mini-Monoka stent, whereas the remaining 29 cases underwent only excision. At final follow up, a healed punctal opening was visible in 46 of 50 (92%) of the cases; 2 (4%) cases had a slit-like punctum and in 1 case (2%), a stenosed punctum was visible. However, only 1 case (2%) reported epiphora at follow up.

Conclusions: Peripunctal masses are largely benign and present most commonly on the lower eyelid. Melanocytic nevus is the most common peripunctal mass lesion. In the series, stent placement did not play a significant role in the functional outcome.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Eyelid Neoplasms* / pathology
  • Humans
  • Lacrimal Apparatus Diseases* / diagnosis
  • Lacrimal Apparatus Diseases* / surgery
  • Middle Aged
  • Nevus, Pigmented* / pathology
  • Nevus, Pigmented* / surgery
  • Retrospective Studies
  • Sebaceous Gland Neoplasms* / pathology
  • Skin Neoplasms* / pathology
  • Sweat Gland Neoplasms*
  • Treatment Outcome
  • Young Adult