An Unusual Lacrimal Gland Mass

JOURNAL TITLE: An International Journal Clinical Rhinology

Author
1. Savleen Kaur
2. Rakesh Vasishta
3. Pankaj Gupta
4. Zoramthara Zadeng
5. Manpreet Singh
ISSN
0974-4630
DOI
10.5005/jp-journals-10013-1357
Volume
12
Issue
2-3
Publishing Year
2019
Pages
3
Author Affiliations
    1. Department of Ophthalmology, Postgraduate Institution of Medical Education and Research, Chandigarh, India
    1. Postgraduate Institute of Medical Education and Research, Chandigarh, India
    2. Postgraduate Institute of Ophthalmology, Chandigarh, India
    3. Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    4. Postgraduate Institute of Medical, Education and Research, Chandigarh, India
    1. Department of Ophthalmology, Postgraduate Institution of Medical Education and Research, Chandigarh, India
    1. Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    1. University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi
    2. University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, manpreetdawar@hotmail.com
    3. Government Medical College and Hospital, Sector-32, Chandigarh, India
    4. Government Medical College and Hospital, Chandigarh, India
  • Article keywords

    Abstract

    Aim and objective: The present report describes an atypical presentation of a lacrimal gland mass in a young male patient. Symptomatology favored a benign mass that was proven to be malignant on histopathology. Background: Adenoid cystic carcinoma is the most common epithelial malignancy of the lacrimal gland. The usual presentation of adenoid cystic carcinoma is in either sex at about an average 40 years of age with range from 6 to 79 years. The patient usually complains of a superotemporal orbital mass with rapid progression usually within a year. Uncommonly, these masses may present with longer history as is described in present case report. Case description: A 17-year-old male patient of Indian origin presented with a mass in the superotemporal part of the right orbit for the last 5 years and 6 months. A firm and smooth orbital mass, approximately 20 mm × 15 mm, was present in superotemporal orbit that was nontender and nonpulsatile. A clinical diagnosis of lacrimal gland pleomorphic adenoma was strongly suggested by the clinical as well as radiological features. The orbital mass was excised en bloc by a right transseptal anterior orbitotomy. Histopathological examination of the excised mass revealed features characteristic of lacrimal gland adenoid cystic carcinoma. Conclusion: Lacrimal gland adenoid cystic carcinoma can simulate pleomorphic adenoma and can present with history over 5 years. Hence, it should always be kept as a clinical possibility in patients with the painless superotemporal orbital mass and early excision of such orbital masses for appropriate diagnosis and management is vital. Clinical significance: The duration of 5½ years at presentation in well-localized lacrimal gland adenoid cystic carcinoma is the longest period ever reported. The present article recommends keeping the differential diagnosis of adenoid cystic carcinoma in all patients with the clinically benign superotemporal orbital mass.

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