Abstract
Lacrimal gland tumors are common in middle age group individuals. Proptosis is one of their common presentations. Sometimes the tumors may undergo malignant changes which if neglected can be life threatening. Here we present a case of 49 years male with gradual painless protrusion and diminution of vision in his right eye for eight years and more since last 2 months, with restriction of ocular motility in right lateral gaze. Expecting a benign mass, superolateral orbitotomy with excisional biopsy was done which astonishingly revealed carcinoma ex pleomorphic adenoma with components of adenocarcinoma and squamous cell carcinoma without any lymphovascular invasion. Proptosis and vision of the patient in right eye improved post excisional biopsy without any residual mass in respective follow ups.
Highlights
The lacrimal glands, a tubuloacinar glands, one for each eye, secretes the aqueous layer of the tear film.[1]
Pleomorphic adenomas are most common benign lesion whereas carcinoma ex pleomorphic adenoma is the second most common malignant lesion with variable prognosis.[6]. This case report basically shows the malignant transformation of their benign counterpart in short span of time that sometimes can go overlooked
Since no similar cases have been reported from Nepal, this case report may help others in understanding and diagnosing such cases
Summary
The lacrimal glands, a tubuloacinar glands, one for each eye, secretes the aqueous layer of the tear film.[1]. There is need for detail evaluation in any cause of proptosis, especially with recent change in its presentations. A 49 years male presented with gradual painless protrusion and diminution of vision in right eye for 8 years, more since last 2 months (Figure 1).
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