Alfin R J, Alada J J, Okwudire-Ejeh I, Mosugu O, Ramyil A V
Department of Surgery and Ophthalmology, College of Medicine & Health Sciences, Bingham University, Jos, Plateau State, Nigeria.
Department of Ophthalmology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
J West Afr Coll Surg. 2020 Jan-Mar;10(1):26-29. doi: 10.4103/jwas.jwas_35_21. Epub 2022 Mar 5.
Mucoepidermoid carcinoma (MEC), a tumour previously believed to occur exclusively in the major salivary glands, was atypically recognized in the lacrimal gland. Few ophthalmologists are familiar with this rare neoplasm.
This case is being reported for its rarity and the association with human immunodeficiency virus (HIV).
High-grade MEC of the lacrimal gland of the right eye was diagnosed in an orbital exenteration specimen of a 60-year-old HIV-positive man. He presented to the eye unit of a mission hospital in Jos, Nigeria with significant visual impairment in the right eye and a rapidly growing painful superolateral orbital mass. The tumour invaded and completely obliterated the anterior chamber. The lens, ciliary body, and iris were displaced posteriorly but were free from tumour infiltration. The tumour was exenterated, and the patient was subsequently referred for adjuvant radiotherapy. No evidence of recurrence or metastasis has been noted 15 months post-surgery.
Early and decisive surgical intervention in a case of high-grade MEC of the lacrimal gland is crucial in forestalling local invasion as well as distant metastasis. Because of the possibility of local recurrence, adjuvant radiotherapy is required and close follow-up of the patient is warranted.
黏液表皮样癌(MEC)是一种先前被认为仅发生于大唾液腺的肿瘤,却在泪腺中被非典型地发现。很少有眼科医生熟悉这种罕见肿瘤。
报道该病例是因其罕见性以及与人类免疫缺陷病毒(HIV)的关联。
一名60岁的HIV阳性男性的眼眶内容剜出标本中诊断出右眼泪腺的高级别MEC。他因右眼严重视力损害和右上外侧眼眶迅速生长的疼痛性肿块就诊于尼日利亚乔斯一家教会医院的眼科。肿瘤侵犯并完全阻塞前房。晶状体、睫状体和虹膜向后移位,但未受肿瘤浸润。肿瘤被剜出,患者随后被转诊接受辅助放疗。术后15个月未发现复发或转移迹象。
对于泪腺高级别MEC病例,早期且果断的手术干预对于防止局部侵犯和远处转移至关重要。由于存在局部复发的可能性,需要进行辅助放疗并对患者进行密切随访。