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Case Reports
. 2021 Jun;39(2):152-158.
doi: 10.3857/roj.2021.00122. Epub 2021 Jun 28.

Lacrimal gland adenoid cystic carcinoma: report of an unusual case with literature review

Kenza Benali  1   2 , Houda Benmessaoud  1   2 , Jihan Aarab  1   2 , Abdelati Nourreddine  1   3 , Hanan El Kacemi  1   2 , Sanaa El Majjaoui  1   2 , Tayeb Kebdani  1   2 , Noureddine Benjaafar  1   2
Affiliations
Case Reports

Lacrimal gland adenoid cystic carcinoma: report of an unusual case with literature review

Kenza Benali et al. Radiat Oncol J. 2021 Jun.

Abstract

Lacrimal gland adenoid cystic carcinomas are rare, aggressive orbital tumors characterized by poor overall prognosis, tendency for local recurrence and metastasis despite aggressive treatment. Treatment continues to be controversial. Many authorities today will often initiate surgery (orbital exenteration with or without bone removal vs. globe-sparing resection) and adjuvant radiotherapy (external beam or proton beam therapy). We introduce a case of lacrimal gland adenoid cystic carcinoma treated with orbital exenteration and adjuvant volumetric modulated arc therapy, and discuss the related literature.

Keywords: Adenoid cystic carcinoma; Adjuvant radiotherapy; Lacrimal gland; Orbital exenteration; Volumetric arc therapy.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Preoperative orbital magnetic resonance imaging (MRI). (A) Axial T1-weighted Gadolinium enhanced MRI showing heterogeneous contrast enhancing lesion involving the left orbit. (B, C) Axial T2-weighted images showing isointense soft tissue mass in the lateral aspect of the left orbit.
Fig. 2.
Fig. 2.
(A, B) Axial views of the planning computed tomography scan showing the target volumes: preoperative GTV in red, CTV-HR and PTV-HR in yellow and green, respectively. (C) Volumetric modulated arc therapy was delivered via to the region of high risk, using a 0.5-cm thick bolus (in blue), to doses of 66 Gy (95% isodose line in orange). GTV, gross tumor volume; CTV, clinical target volume; PV, planning target volume; HR, high risk.
Fig. 3.
Fig. 3.
(A–C) Consecutive axial views from superior to inferior of the planning CT scan with 66 Gy (100%; in red) and 62.7 Gy (95%; in orange) isodose lines.
Fig. 4.
Fig. 4.
Dose-volume histogram distribution of the following structures: planning target volume (green), chiasma (orange), left temporal lobe (purple), right temporal lobe (cyan), spinal cord (red), brainstem (dark green), right optic nerve (dark blue), right retina (pink), right lens (blue), and right globe (yellow).
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