Yang Hsin-Yu, Wu Cheng-Hsien, Tsai Chieh-Chih, Yu Wei-Kuang, Kao Shu-Ching, Liu Catherine Jui-Ling
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Taiwan J Ophthalmol. 2018 Jan-Mar;8(1):42-48. doi: 10.4103/tjo.tjo_3_18.
A 64-year-old male presented with progressive proptosis of the left eye for 3 months. Orbital computed tomography (CT) demonstrated a 3.9 cm infiltrative mass over the superotemporal quadrant of the left orbit. Pathology of biopsy revealed a ductal adenocarcinoma of lacrimal gland with positive immunohistochemical staining for androgen receptor (AR), cytokeratin-7 (CK7), and gross cystic disease fluid protein 15 (GCDFP-15). The patient received orbital exenteration and adjuvant chemoradiotherapy. No recurrence or metastasis was noted 27 months after treatment. Another case was a 64-year-old male who came for proptosis of the right eye and diplopia for 3 weeks. Orbital CT revealed a 5 cm infiltrated right superotemporal orbital mass with destruction of the lateral and inferior orbital walls. Biopsy showed primary ductal adenocarcinoma of lacrimal gland with positive immunohistochemical staining for CK7, AR, and epidermal growth factor receptor. The patient underwent exenteration and concomitant chemoradiotherapy. However, lung and neck metastasis was noted 21 months after surgery. Collectively, 26 cases in the literature were reviewed. The mean age was 57 years old and male was prevalent (73%). Most immunohistological staining showed positive for AR (46%), CK7 (46%), Ki-67 (38%), and GCDFP-15 (35%). More than half of the patients developed metastasis and one-third of the patients died of disease. Early diagnosis, treatment, and long-term follow-up are required for this aggressive tumor.
一名64岁男性，左眼进行性眼球突出3个月。眼眶计算机断层扫描（CT）显示左眼眶颞上象限有一个3.9厘米的浸润性肿块。活检病理显示为泪腺导管腺癌，雄激素受体（AR）、细胞角蛋白-7（CK7）和 gross cystic disease fluid protein 15（GCDFP-15）免疫组化染色呈阳性。患者接受了眼眶内容剜除术及辅助放化疗。治疗27个月后未发现复发或转移。另一例是一名64岁男性，因右眼眼球突出和复视3周前来就诊。眼眶CT显示右颞上眶有一个5厘米的浸润性肿块，眼眶外侧壁和下壁破坏。活检显示为泪腺原发性导管腺癌，CK7、AR和表皮生长因子受体免疫组化染色呈阳性。患者接受了内容剜除术及同步放化疗。然而，术后21个月发现有肺和颈部转移。综合来看，对文献中的26例病例进行了回顾。平均年龄为57岁，男性居多（73%）。大多数免疫组织化学染色显示AR（46%）、CK7（46%）、Ki-67（38%）和GCDFP-15（35%）呈阳性。超过一半的患者发生转移，三分之一的患者死于该疾病。对于这种侵袭性肿瘤，需要早期诊断、治疗和长期随访。
