Pleomorphic adenoma of retrobulbar ectopic lacrimal gland: a rare occurrence
Abstract
Ectopic lacrimal gland encompasses all lacrimal tissue that is outside the lacrimal gland fossa, excluding the accessory glands of Krause and of Wolfring. The bulbar conjunctiva and limbus are most commonly involved regions while retrobulbar region is unusual. This tissue may undergo neoplastic transformation, the commonest tumour being pleomorphic adenoma. A 30 year old male presented with painless loss of vision and mild proptosis of the right eye since 5 months. MRI disclosed a well-defined, lobulated contrast enhancing mass in the right retrobulbar region measuring 2 X 2 X 2 cm and a differential diagnosis of vascular or glial neoplasm was entertained. Excision biopsy revealed an encapsulated mass away from the lacrimal fossa. Histopathology showed features of pleomorphic adenoma which was confirmed on IHC.
Downloads
References
Alyahya GA, Bangsgaard R, Prause JU, Heegaard S.Occurrence of lacrimal glandtissueoutside the lacrimalfossa: comparison of clinical and histopathologicalfindings. Acta Ophthalmol Scand. 2005 Feb;83(1):100-3.
McCulley TJ, Yip CC, Kersten RC, Kulwin DR. An ectopic site of lacrimal gland secretion mimicking epiphora. Arch Ophthalmol. 2002 Nov;120(11):1586-7.
Lee WR, Aitken DA, Kirkness CM. Diffuse hyperplasia of intratarsal ectopic lacrimal gland tissue. Arch Ophthalmol. 2002 Dec;120(12):1748-52.
Pe'er J, Ilsar M. Ectopic lacrimal gland under the nasal mucosa. Am J Ophthalmol. 1982 Sep;94(3):418-9.
Pfaffenbach DD, Green WR. Ectopic lacrimal gland.IntOphthalmolClin. 1971 Fall;11(3):149-59.
Pokorny KS, Hyman BM, Jakobiec FA, Perry HD, Caputo AR, Iwamoto T. EpibulbarChoristomas Containing Lacrimal Tissue: Clinical Distinction from Dermoids and Histologic Evidence of an Origin from the Palpebral Love. Ophthalmology. 1987; 94(10): 1249-57.
Sakurai H, Mitsuhashi N, Hayakawa K, Nozaki M, Kurosaki H, Kishi S, Joshita T, Niibe H. Ectopic lacrimal gland of the orbit. J Nucl Med. 1997 Sep;38(9):1498-500.
Adel H. Alsuhaibani MD. Slow-growing large pleomorphic adenoma of ectopic lacrimal gland tissue in the upper eyelid. Saudi Journal of Ophthalmology 2012; 26(4): 453-5.
Duke-Elder S, Cook C. Normal and abnormal development. Part I. Embryology. In: Duke-Elder S, editor. System of Ophthalmology, Vol. III. London. Kimpton; 1963.
Jakobiec F, Iwamoto T. Ocular adnexae: introduction tolids, conjunctiva and orbit. In: Jakobiec F, editor, Ocular Anatomy,Embryologyand Teratology. Philadelphia. Harper & Row; 1982.
Ozanics V, Jakobiec F. Prenatal development of the eye and its adnexa. In: Jakobiec F, editor, Ocular Anatomy, Embryology and Teratology. Philadelphia. Harper & Row; 1982.
Nikhil, Kaushik C. Ectopic lacrimal gland in the eyelids (a case report). Indian J Ophthalmol. 1985 Jan-Feb;33(1):65-6.
Font RL, Smith SL, Bryan RG. Malignant epithelial tumors of the lacrimal gland: a clinicopathologic study of 21 cases. Arch Ophthalmol. 1998 May;116(5):613-6.
Weis E, Rootman J, Joly TJ, Berean KW, Al-Katan HM, Pasternak S, Bonavolontà G, Strianese D, Saeed P, Feldman KA, Vangveeravong S, Lapointe JS, White VA. Epithelial lacrimal gland tumors: pathologic classification and current understanding. Arch Ophthalmol. 2009 Aug;127(8):1016-28. doi: https://doi.org/10.1001/archophthalmol.2009.209.
Yamada T, Kato T, Hayasaka S, Hayasaka Y, Kadoi C. Benign pleomorphic adenomaarising from the palpebrallobe of the lacrimal glandassociated with elevatedintraocular pressure. Ophthalmologica. 1999;213(4):269-72.
Saini JS, Mukherjee AK, Naik P. Pleomorphic adenoma of Krause's gland in lower lid. Indian J Ophthalmol. 1985 May-Jun;33(3):181-2.
Alyahya GA, Stenman G, Persson F, Prause JU, Skjødt K, Saunte JP, Heegaard S.Pleomorphic adenomaarising in an accessorylacrimal gland of Wolfring.Ophthalmology. 2006 May;113(5):879-82. Epub 2006 Mar 13.
Patyal S, Banarji A, Bhadauria M, Gurunadh VS. Pleomorphic adenoma of a subconjunctival ectopic lacrimal gland. Indian J Ophthalmol. 2010 May-Jun;58(3):245-7. doi: https://doi.org/10.4103/0301-4738.62656
Mindlin A, Lamberts D, Barsky D. Mixed lacrimal gland tumor arising from ectopic lacrimal gland tissue in the orbit. J PediatrOphthalmol 1977; 14(1): 44–47.
Mueller EC, Borit A. Aberrant lacrimal gland and pleomorphic adenoma within the muscle cone. Ann Ophthalmol. 1979 Apr;11(4):661-3.
Mokkapati PK, Mahapatra M, Satish K, Ram K. Giant pleomorphic adenoma of lacrimal gland presenting with diminished vision–a case report. Asian Journal of Ophthalmology. 2015; 14(2): 83-6.
Misra S, Bhandari A, Misra N, Gogri P, Mahajan S.Pleomorphic adenoma of a deeporbitalectopiclacrimal gland. Orbit. 2016 Oct;35(5):295-7. doi: https://doi.org/10.1080/01676830.2016.1193526.
Lloyd GA. Lacrimal gland tumours: the role of CT and conventional radiology. Br J Radiol. 1981 Dec;54(648):1034-8.
Rose GE, Wright JE. Pleomorphic adenoma of the lacrimal gland. Br J Ophthalmol. 1992 Jul;76(7):395-400.
Barnes L, Eveson J, Reichart P, Sidransky D. Pathology and Genetics of Tumours of the Head and Neck. Lyon. International Agency for Research on Cancer; 2005.
Chan JKC, Cheuk W. Tumours of the salivary glands. In: Fletcher CD, editor. Diagnostic Histopathology of Tumours, Volume 1. 4th ed. Philadelphia. Elsevier Saunders; 2013.
OAI - Open Archives Initiative
