Abstract ID: 26-520
Late-Onset Solitary Lacrimal Gland Metastasis from Clear Cell Renal Cell Carcinoma 14 Years After Primary Resection
Author: María Asunción Sierra Marín Base Hospital / Institution: Hospital Virgen de Valme
Presentation Type: ePoster Presentation
Purpose
To report a rare case of a late-onset metastasis of clear cell renal cell carcinoma (ccRCC) to the lacrimal gland presenting 14 years after the initial nephrectomy, and to emphasize the critical importance of long-term oncological history in the differential diagnosis of lacrimal gland masses.
Methods
Case report and clinical review of a 70-year-old male with a history of right ccRCC in 2011 (treated with nephrectomy and adjuvant therapy) and a pancreatic metastasectomy in 2014 who presented in October 2025 with a 2-week history of right upper eyelid swelling, erythema, and mild pain.
Results
Initial examination revealed a tender, mobile, and elastic mass in the right lacrimal gland region. Presumed dacryoadenitis was treated with oral antibiotics and anti-inflammatories, followed by oral deflazacort (30mG/day), yielding partial symptomatic relief but persistence of the mass. Blood analysis, including extensive autoimmune and infectious panels, was unremarkable. Due to renal insufficiency, a non-contrast orbital CT was performed, revealing a well-defined enlargement of the right lacrimal gland in close contact with the lateral rectus muscle, without intraconal fat infiltration. An incisional biopsy of the right lacrimal gland was performed. Histopathological evaluation confirmed a1.5cm metastasis of clear cell renal cell carcinoma (Fuhrman Grade I), with surgical margins at less than 1mm and no infiltration of the adjacent adipose tissue.
Conclusion
Renal cell carcinoma is notorious for its unpredictable behavior and multi-organ metastatic potential, yet secondary involvement of the lacrimal gland is extraordinarily rare. This case highlights two major clinical challenges: the presentation of a metastatic lesion mimicking benign dacryoadenitis, and an exceptionally prolonged latency period of 14 years between the primary tumor and orbital recurrence. Clinicians must maintain a high index of suspicion and obtain an exhaustive oncological history in patients presenting with lacrimal gland masses, as late-onset metastases can occur over a decade after apparent clinical remission.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Cristina | Escorial Albendiz | Hospital Virgen de Valme |