B. P. Koirala Lions Centre for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Nepal J Ophthalmol. 2023 Jul;15(30):89-96. doi: 10.3126/nepjoph.v15i2.57325.
Lacrimal gland adenoma is a benign tumour of the lacrimal gland mostly involving the orbital part of the gland and composed of epithelial and myoepithelial components. It involves the third and fourth decade of life as a gradual painless enlargement of the lacrimal gland.
This is a case report of a 30-year-old female presenting with the forward bulging of the right eye causing the eye to be displaced medio-inferiorly over the course of one year. After careful clinical examination and MRI, a clinical diagnosis of lacrimal gland adenoma was established and was planned for right lateral orbitotomy (without marginotomy) via eyelid crease incision and transcutaneous-transseptal approach with complete excision of the tumour under general anaesthesia.
This case was presented to the out patient department with mild painful non-axial proptosis of the right eye. After clinical examination, her MRI report showed a well-defined altered signal intensity enhancing lesion on the extraconal compartment of the right orbit in the antero-supero-lateral aspect. After complete surgical removal of the mass, it was sent for histopathological analysis and it confirmed it as a pleomorphic adenoma. The patient has been following up every 6 months for 2 years and is asymptomatic.
Being the most prevalent lacrimal gland tumour, pleomorphic adenoma affects the unilateral lacrimal gland causing non-axial proptosis. Complete removal of mass has an excellent prognosis with complete resolution of symptoms.
泪腺腺瘤是一种泪腺良性肿瘤,主要累及眶部,由上皮和肌上皮成分组成。它发生于生命的第三和第四个十年,表现为泪腺无痛性逐渐增大。
这是一例 30 岁女性病例,其右眼向前突出,导致眼球在一年的时间内向中下方向移位。经过仔细的临床检查和 MRI,临床诊断为泪腺腺瘤,并计划通过眼睑皱褶切口和经皮经筛窦入路行右侧外侧眶切开术(无眶缘切除术),全身麻醉下彻底切除肿瘤。
该病例以右眼轻度疼痛性非轴性眼球突出为主诉就诊于门诊。临床检查后,其 MRI 报告显示右侧眶外腔前上外侧可见界限清楚的信号强度改变,增强病变。肿块完全切除后,行组织病理学分析,证实为多形性腺瘤。患者已随访 2 年,每 6 个月随访一次,无症状。
多形性腺瘤是最常见的泪腺肿瘤,累及单侧泪腺,引起非轴性眼球突出。肿块完全切除具有良好的预后,症状完全缓解。