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Lacrimal gland carcinoma ex pleomorphic adenoma with chronic lymphocytic leukemia infiltration.

Couceiro R, Loureiro C, Luís P, López-Presa D, Proença H, Fonseca A, Monteiro-Grillo M - Clin Ophthalmol (2014)

Bottom Line: Subsequently, lesion volume growth and bone erosion were documented on orbital computed tomography.Lateral orbitectomy and lacrimal gland resection were performed.This case highlights the importance of persistent investigation of clinically suspicious orbital lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal.

ABSTRACT

Purpose: To report a rare case of lacrimal gland carcinoma ex pleomorphic adenoma (Ca ex PA) with chronic B-cell lymphocytic leukemia (B-CLL) infiltration in a patient without a previous diagnosis of B-CLL.

Patient and methods: We report a 66-year-old woman who presented with recent worsening of a long-standing right eye proptosis. Sequential orbital computed tomography imaging was performed over the course of 2 years, and biopsy specimens were analyzed.

Results: Initial computed tomography scans revealed a lacrimal gland lesion with stable dimensions for more than 1 year and no malignancy features on incisional biopsy. Subsequently, lesion volume growth and bone erosion were documented on orbital computed tomography. Lateral orbitectomy and lacrimal gland resection were performed. Pathology and immunohistochemistry detected Ca ex PA with B-CLL infiltration.

Conclusion: This case highlights the importance of persistent investigation of clinically suspicious orbital lesions. To our knowledge, this is the first description of a case of lacrimal gland Ca ex PA with B-CLL infiltration.

No MeSH data available.


Related in: MedlinePlus

Orbital computed tomography.Notes: (A) Coronal section. (B) Transverse section. Showing a mass lesion in the right lacrimal gland, with regular borders and internal heterogeneity, determining an inferior and medial deviation of orbital structures.
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f1-opth-8-2061: Orbital computed tomography.Notes: (A) Coronal section. (B) Transverse section. Showing a mass lesion in the right lacrimal gland, with regular borders and internal heterogeneity, determining an inferior and medial deviation of orbital structures.

Mentions: Lacrimal gland incisional biopsy identified scarce lymphoplasmacytic inflammatory infiltrates and some hyperplasia of glandular tissue, but no malignancy features. After careful consideration, taking the biopsy results into account as well as the absence of malignancy suspicion on CT imaging, we decided on close monitoring of the patient. She did not report further worsening of symptoms; however, a subsequent orbital CT scan performed 2 years after the patient was admitted to our institution revealed a substantial growth of the lacrimal gland lesion, showing internal heterogeneity and evidence of osteolysis of the lateral orbital wall with orbital remodeling (Figure 1A, B).


Lacrimal gland carcinoma ex pleomorphic adenoma with chronic lymphocytic leukemia infiltration.

Couceiro R, Loureiro C, Luís P, López-Presa D, Proença H, Fonseca A, Monteiro-Grillo M - Clin Ophthalmol (2014)

Orbital computed tomography.Notes: (A) Coronal section. (B) Transverse section. Showing a mass lesion in the right lacrimal gland, with regular borders and internal heterogeneity, determining an inferior and medial deviation of orbital structures.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199789&req=5

f1-opth-8-2061: Orbital computed tomography.Notes: (A) Coronal section. (B) Transverse section. Showing a mass lesion in the right lacrimal gland, with regular borders and internal heterogeneity, determining an inferior and medial deviation of orbital structures.
Mentions: Lacrimal gland incisional biopsy identified scarce lymphoplasmacytic inflammatory infiltrates and some hyperplasia of glandular tissue, but no malignancy features. After careful consideration, taking the biopsy results into account as well as the absence of malignancy suspicion on CT imaging, we decided on close monitoring of the patient. She did not report further worsening of symptoms; however, a subsequent orbital CT scan performed 2 years after the patient was admitted to our institution revealed a substantial growth of the lacrimal gland lesion, showing internal heterogeneity and evidence of osteolysis of the lateral orbital wall with orbital remodeling (Figure 1A, B).

Bottom Line: Subsequently, lesion volume growth and bone erosion were documented on orbital computed tomography.Lateral orbitectomy and lacrimal gland resection were performed.This case highlights the importance of persistent investigation of clinically suspicious orbital lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal.

ABSTRACT

Purpose: To report a rare case of lacrimal gland carcinoma ex pleomorphic adenoma (Ca ex PA) with chronic B-cell lymphocytic leukemia (B-CLL) infiltration in a patient without a previous diagnosis of B-CLL.

Patient and methods: We report a 66-year-old woman who presented with recent worsening of a long-standing right eye proptosis. Sequential orbital computed tomography imaging was performed over the course of 2 years, and biopsy specimens were analyzed.

Results: Initial computed tomography scans revealed a lacrimal gland lesion with stable dimensions for more than 1 year and no malignancy features on incisional biopsy. Subsequently, lesion volume growth and bone erosion were documented on orbital computed tomography. Lateral orbitectomy and lacrimal gland resection were performed. Pathology and immunohistochemistry detected Ca ex PA with B-CLL infiltration.

Conclusion: This case highlights the importance of persistent investigation of clinically suspicious orbital lesions. To our knowledge, this is the first description of a case of lacrimal gland Ca ex PA with B-CLL infiltration.

No MeSH data available.


Related in: MedlinePlus