A case report: An unusual presentation of lacrimal gland tumor.
Author: SAJA ALJOHANI
Base Hospital / Institution: Jeddah eye hospital
ePoster presentation
Abstract ID: 25-477
Purpose
Primary ductal adenocarcinoma of the lacrimal gland (PDALG) is an exceedingly rare. The incidence of lacrimal gland tumors is generally low, with a notable male preponderance.
Methods
Case
Results
We present the case of a 32-year-old female patient of Filipino origin who presented with a right upper lid swelling of one month’s duration. She experienced intermittent numbness over the right side of the scalp as well as intermittent headaches.
examination revealed 6/6 (VA) on Snellen’s chart, with normal color vision. IOP was within normal limits. Extraocular muscles were intact, and Hertel’s exophthalmometry measurements were: 110mm base, 18mm OD, and 16mm OS. A firm mobile mass was observed on the right upper eyelid; otherwise, the eyelid apparatus measurements were within normal limits with no evidence of ptosis or cranial nerve affection. Initial (MRI) revealed the presence of a right lacrimal gland mass. The lesion demonstrated low signal intensity in the T1 pre-contrast sequences and almost enhanced in the axial view after contrast administration.
Upon excisional biopsy, we encountered a 1.5-cm well-capsulated mass, resembling a pleomorphic adenoma; however, further dissection was hindered by adherence to the glandular tissue and the lateral horn of the levator muscle. One week postoperatively, the patient was satisfied with the results, without any postoperative complications. A month later, progressive ptosis in the right eye had developed, with pain and numbness over the right eyelid and scalp.
Histopathological examination revealed neoplastic polygonal cells with eosinophilic cytoplasm, arranged in glandular, cribriform, and solid patterns, along with areas of central necrosis. A diagnosis of high-grade invasive ductal carcinoma of the lacrimal gland was made. the patient was referred for a comprehensive metastatic workup which revealed liver and lung metastases, chemotherapy was prescribed.
Conclusion
In conclusion, our case emphasized the aggressiveness and diagnostic complexity of PDALG, as initial findings mimicked benign tumors despite metastases present at diagnosis.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Abdulelah | Abumohssin | |
| Rawan | Malaikah | jeddah eye hospial |
