Primary adenoid cystic carcinoma of the conjunctiva arising from the accessory lacrimal glands: a clinicopathologic study of three cases.

PURPOSE

To report 3 cases of primary adenoid cystic carcinoma originating from the accessory and/or ectopic lacrimal glands of the conjunctiva.

METHODS

We examined 3 conjunctival tumors histopathologically. The specimens were fixed in 10% formalin. Sections were cut at 5 microm, and the slides were stained with hematoxylin-eosin, periodic acid-Schiff, alcian blue, and colloidal iron methods.

RESULTS

We report 3 conjunctival tumors that histopathologically proved to be adenoid cystic carcinomas that had arisen from the accessory lacrimal glands of the conjunctiva (cases 1 and 2) and from ectopic lacrimal gland tissue (case 3). The age of the patients ranged between 53 and 68 years. In 2 of the cases, the tumor involved the tarsal conjunctiva. The third patient had a mass involving the limbal conjunctiva and two thirds of the cornea inferiorly. Histopathologically, acini of accessory lacrimal glands of the conjunctiva were found near the neoplastic lobules in 2 of the tumors. Foci of perineural invasion were observed in 1 of the tumors (case 1). Follow-up examination showed no evidence of recurrence or metastatic disease in cases 1 and 2 (10 and 8 years, respectively). In case 3, the patient was alive and without any evidence of recurrence 1 year after surgical excision of the mass.

CONCLUSIONS

Adenoid cystic carcinoma arising from the accessory lacrimal glands of the conjunctiva is a rare occurrence. Only 2 previously reported cases have appeared in the literature, and to our knowledge, there are no reports of this tumor arising from ectopic lacrimal gland tissue in the conjunctiva. Follow-up studies are mandatory to evaluate the biologic behavior of the tumor.