Maamari Robi N, Custer Philip L, Harocopos George J
Washington University School of Medicine, Saint Louis, Missouri, USA.
Ocul Oncol Pathol. 2017 Nov;3(4):262-266. doi: 10.1159/000461585. Epub 2017 Apr 1.
To report a rare presentation of adenoid cystic carcinoma (ACC) of the lacrimal gland.
This is a case report presenting clinical, radiographic, and histopathologic findings.
A 72-year-old female with no reported ocular symptoms was found to have an incidental right orbital mass on imaging. Additional studies revealed multiple liver lesions, which were biopsied and found to be consistent with ACC. She was then referred to the ophthalmology service, where ocular examination demonstrated 2.5 mm of right proptosis with elevation and abduction deficits. Diplopia could be elicited in extreme upgaze and right lateral gaze. An excisional biopsy of the orbital mass was performed, with histopathology confirming the diagnosis of primary ACC of the lacrimal gland, thereby also supporting the initial suspicion that the hepatic ACC lesions represented metastases.
The authors describe a rare presentation of ACC of the lacrimal gland, initially asymptomatic, with metastatic lesions restricted to the liver at the time of diagnosis. Three previous cases of ACC with isolated metastatic hepatic lesions at the time of diagnosis have been reported; all of these cases localized the primary tumor to the salivary glands.
报告泪腺腺样囊性癌（ACC）的一种罕见表现。
这是一篇病例报告，展示了临床、影像学和组织病理学检查结果。
一名72岁女性，无眼部症状报告，影像学检查偶然发现右侧眶内肿块。进一步检查发现肝脏有多个病灶，经活检确定与ACC相符。随后她被转诊至眼科，眼部检查显示右眼眼球突出2.5毫米，伴有上转和外展功能障碍。极度向上注视和右侧注视时可引出复视。对眶内肿块进行了切除活检，组织病理学确诊为泪腺原发性ACC，这也支持了最初关于肝脏ACC病灶为转移灶的怀疑。
作者描述了泪腺ACC的一种罕见表现，最初无症状，诊断时转移灶局限于肝脏。此前已报告过3例诊断时孤立性肝转移的ACC病例；所有这些病例的原发肿瘤均位于唾液腺。
