Pleomorphic adenoma of lacrimal gland

Abstract

We present a case of a 62-year-old male patient with pleomorphic adenoma and painless solid mass in his right eye. Computerized tomography demonstrated a mass with a diameter of 2.5 cm located in the right lacrimal gland. The mass was removed completely by combined orbitofrontal craniotomy through a transcranial approach. Histopathologic examination revealed pleomorphic adenoma of the lacrimal gland. Orbital tumors originate primarily from vascular, muscle, cartilage, neural tissues, lacrimal glands and lymphoid structures. Five percent of all intraorbital masses originate from the lacrimal gland. Pleomorphic adenoma presents as a painless and slowly growing mass and also as exophthalmoses. Pleomorphic adenoma has a high morbidity. Morbidity increases due to the total displacement of the tumor without its capsule and incisional biopsy for the purpose of diagnosis. The success of the treatment depends on the removal of the tumor with its capsule.

Figure 1:

(A and B) Computerized tomography revealed a homogenously contrasted intraorbital mass in the right eye.

Figure 2:

(A and B) Cranial MRI revealed a homogenously contrasted mass on the superolateral part of the right orbita.

Figure 3:

(A and B) Postoperative computerized tomography revealed the replacement of the eye.

Figure 4:

(A) Four times H-E biphasic tumor composed of epithelial and stromal components. (B) Ten times H-E fibromyxoid stroma and epithelium that form glandular structures. (C) Twenty times H-E cartilaginous focus in the stroma. (D) Four times H-E keratinized plugs in some glandular lumens.