Journal List > J Korean Ophthalmol Soc > v.52(2) > 1008980

Jung, Cho, and La: A Giant Pleomorphic Adenoma of Lacrimal Gland Involving the Palpebral Lobe Causing Severe Mechanical Ptosis

Abstract

Purpose

To report a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe causing severe mechanical ptosis and visual field defect, which was removed successfully.

Case Summary

An 82-year-old man visited our clinic with a large protruding mass on his left upper lid that had grown for approximately 10 years causing severe ptosis. Preoperative orbital CT showed a 2.3 × 2.0 cm sized large mass which was suspicious of hemangioma. The mass was completely excised through a lid crease incision. The histopathologic examination showed typical findings of pleomorphic adenoma. After the surgery, preoperative mechanical ptosis was completely resolved and during the 6 months of followup, there was no abnormality of tear secretion and evidence of tumor recurrence.

Conclusions

The authors experienced a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe and resolved mechanical ptosis by complete removal of the tumor through a lid crease incision.

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Figure 1.
Photographs show a huge protruding upper lid mass causing severe mechanical ptosis.
jkos-52-241f1.tif
Figure 2.
(A) Orbit CT shows a 2.3×2.0 cm sized, round, demarcated huge mass protruding to the upper lid. (B) The mass is contrast enhanced and at first, radiological impression was hemangioma.
jkos-52-241f2.tif
Figure 3.
(A) Through upper lid crease incision and dissection, almost totally exposed mass was seen. (B) The removed mass was well encapsulated and round firm shaped and 2.3×2.0×2.0 cm in size.
jkos-52-241f3.tif
Figure 4.
(A) Histopathologic finding shows numerous tubular or glandular structures embedded in myxoid stroma (hematoxylin- eosin, ×40). (B) The tubules are lined by two layers of cells. The inner layer has columnar epithelial cells with eosinophilic cytoplasm, and the outer layer is made up of myoepithelial cells. Scattered spindle cells in myxoid stroma are also seen (hematoxylin-eosin, ×400).
jkos-52-241f4.tif
Figure 5.
Photograph of the patient at postoperative 1 month shows completely removed upper lid mass and resolved pre-operative severe mechanical ptosis.
jkos-52-241f5.tif
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