Neerukonda Vamsee K, Carruth Bryant, Estopinal Maria Del Valle
Department of Ophthalmology, State University of New York Upstate Medical University, Syracuse, New York, USA.
Eye Plastic and Reconstructive Surgery of Central New York, 3400 Vickery Rd, North Syracuse, NY 13212, USA.
Case Rep Pathol. 2020 Aug 12;2020:6482837. doi: 10.1155/2020/6482837. eCollection 2020.
Lacrimal gland neoplasms comprise up to 18% of all orbital masses clinically and histologically. Much of our current core knowledge regarding lacrimal gland tumors stems from prior study of their more common counterparts, the salivary glands. The prognosis for each lacrimal gland tumor is contingent upon proper clinical evaluation and ultimately the histopathologic diagnosis. We describe a case of an invasive carcinoma ex-pleomorphic adenoma (Ca-ex-PA) with a cystadenocarcinoma component arising from the lacrimal gland in the absence of any previously diagnosed pleomorphic adenoma (benign mixed tumor) or prior incisional surgery. This case illustrates the importance of the histopathologic assessment including immunohistochemistry and genetic testing to narrow a differential diagnosis and potentially aid or guide therapy in the future. Our finding suggests that carcinoma of the lacrimal gland may be derived from previously undiagnosed and perhaps even subclinical pleomorphic adenoma.
泪腺肿瘤在临床上和组织学上占所有眼眶肿物的18%。我们目前关于泪腺肿瘤的许多核心知识源于之前对其更为常见的对应物——唾液腺的研究。每种泪腺肿瘤的预后取决于正确的临床评估以及最终的组织病理学诊断。我们描述了一例泪腺来源的具有囊腺癌成分的侵袭性多形性腺瘤恶变（Ca-ex-PA）病例，该病例之前未诊断出任何多形性腺瘤（良性混合瘤），也未进行过切开手术。该病例说明了组织病理学评估（包括免疫组织化学和基因检测）对于缩小鉴别诊断范围以及未来可能辅助或指导治疗的重要性。我们的发现表明，泪腺癌可能源自之前未被诊断出甚至可能是亚临床的多形性腺瘤。
