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Case Reports
. 2020 Jan-Mar;10(1):26-29.
doi: 10.4103/jwas.jwas_35_21. Epub 2022 Mar 5.

Mucoepidermoid Carcinoma of the Lacrimal Gland: A Case Report

R J Alfin  1 , J J Alada  2 , I Okwudire-Ejeh  3 , O Mosugu  4 , A V Ramyil  2
Affiliations
Case Reports

Mucoepidermoid Carcinoma of the Lacrimal Gland: A Case Report

R J Alfin et al. J West Afr Coll Surg. 2020 Jan-Mar.

Abstract
in English, French

Background: Mucoepidermoid carcinoma (MEC), a tumour previously believed to occur exclusively in the major salivary glands, was atypically recognized in the lacrimal gland. Few ophthalmologists are familiar with this rare neoplasm.

Aim: This case is being reported for its rarity and the association with human immunodeficiency virus (HIV).

Case presentation: High-grade MEC of the lacrimal gland of the right eye was diagnosed in an orbital exenteration specimen of a 60-year-old HIV-positive man. He presented to the eye unit of a mission hospital in Jos, Nigeria with significant visual impairment in the right eye and a rapidly growing painful superolateral orbital mass. The tumour invaded and completely obliterated the anterior chamber. The lens, ciliary body, and iris were displaced posteriorly but were free from tumour infiltration. The tumour was exenterated, and the patient was subsequently referred for adjuvant radiotherapy. No evidence of recurrence or metastasis has been noted 15 months post-surgery.

Conclusion: Early and decisive surgical intervention in a case of high-grade MEC of the lacrimal gland is crucial in forestalling local invasion as well as distant metastasis. Because of the possibility of local recurrence, adjuvant radiotherapy is required and close follow-up of the patient is warranted.

Base: Mucoepidermoid carcinoma (MEC), une tumeur pensée auparavant ne survenir exclusivement que sur les principales glandes salivaires a été étrangement détecté dans la glande lacrimale. Peu d’Opthamologues sont habitués à ce néoplasme.

But: Ce cas est rapporté pour sa rareté et son association avec le Virus de l’Immunodéficience Humaine (VIH).

Présentation de cas: MEC de grade élevé de la glande lacrimale de l’oeil droit a été diagnostiqué sur un specimen d’extenteration orbitale d’un vieil homme de 60 ans, séropositivif. Il présenta à la section des yeux d’un hôpital missionnaire à Jos, Nigeria, un sérieux problème de vision de l’oeil droit et une douleureuse masse orbitale superolatérale poussant très rapidement. La tumeur envahit complètement la membrane/chambre antérieure et l’oblitera. La lentille, le corps ciliaire et l’iris tous déplacés postérieurement étaient épargnés de l’infiltration de la tumeur. La tumeur était exenterisée et le malade recommendé pour une radiothérapie adjuvante. Aucune preuve de resurgence ou de metastasis n’a été enregistrée durant 15 mois d’après chirugie.

Conclusion: Une intervention chirugicale décisive à temps dans un cas de grade élevé de MEC de la glande lacrimale est essentiel à empêcher l’invasion locale aussi bien que le metastasis éloigné. Vu la possibilité de résurgence locale, une radiothérapie adjuvante est nécessaire autant qu’un sérieux suivi du malade.

Keywords: HIV; High grade; lacrimal gland; mucoepidermoid carcinoma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(A-C) A right superotemporal mass with globe infiltration and inferior-nasal displacement
Figure 2
Figure 2
Plain skull X-ray; AP (A) and lateral (B) showing an ill-defined right orbital mass with distinct orbital lines
Figure 3
Figure 3
Right exenteration specimen
Figure 4
Figure 4
Hematoxylin and eosin staining showing tumour mass with ductal spaces (×4)
Figure 5
Figure 5
Hematoxylin and eosin staining showing tumour mass with extravasated mucin and duct formation lined by pleomorphic mucous cells (×40)
Figure 6
Figure 6
Hematoxylin and eosin staining showing pleomorphic epidermoid cells, intermediate cells, and clear cells (×40)
Figure 7
Figure 7
Healthy right orbit 15 months post-primary surgery
See this image and copyright information in PMC

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