Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China.
Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
J Fr Ophtalmol. 2024 Nov;47(9):104291. doi: 10.1016/j.jfo.2024.104291. Epub 2024 Sep 17.
To report the case of a man with well-demarcated cystic lesion in the right lacrimal gland, subsequently diagnosed as primary ductal adenocarcinoma of the lacrimal gland.
We report the clinical presentation, histopathologic, immunohistochemical features and treatment of this unique primary ductal adenocarcinoma of the lacrimal gland. Additionally, we analyze the factors contributing to the tumor's presentation and review the current literature regarding this uncommon neoplasm.
The patient underwent total resection of the mass, revealing primary ductal adenocarcinoma of lacrimal gland. Histopathological examination revealed a solid nested, sieve-like (with observed acne-like necrosis), tubular, and small nested arrangement of the tumor. The tumor cells exhibited marked heterogeneity, and vascular tumor thrombi were observed in the stroma, along with evidence of neurological invasion. The immunophenotype analysis showed positivity for androgen receptor, GATA binding protein 3, gross cystic disease fluid protein 15 and cytokeratin-7, which is considered a ductal adenocarcinoma of lacrimal gland. Subsequently the patient underwent local radiotherapy. No local recurrences or metastases were reported during the 1-year follow-up.
Primary ductal adenocarcinoma of lacrimal gland is a rare tumor of the lacrimal gland. The manifestation of ductal adenocarcinoma of the lacrimal gland may include well-demarcated cystic lesions, indicative of distinct subtypes. Various treatment options are adapted to different subtypes of ductal adenocarcinoma of the lacrimal gland.
报告 1 例发生于右侧泪腺、边界清楚的囊性病变，后被诊断为原发性泪腺导管腺癌的病例。
我们报告了这例独特的原发性泪腺导管腺癌的临床表现、组织病理学、免疫组织化学特征和治疗方法。此外，我们分析了导致肿瘤表现的因素，并回顾了关于这种罕见肿瘤的当前文献。
患者接受了肿块的全切除术，结果显示为原发性泪腺导管腺癌。组织病理学检查显示肿瘤呈实性巢状、筛状（伴有观察到的粉刺样坏死）、管状和小巢状排列。肿瘤细胞表现出明显的异质性，基质中观察到血管肿瘤血栓，并有神经侵犯的证据。免疫表型分析显示雄激素受体、GATA 结合蛋白 3、大体囊性疾病液体蛋白 15 和细胞角蛋白-7 阳性，这被认为是泪腺导管腺癌。随后患者接受了局部放疗。在 1 年的随访中，未报告局部复发或转移。
原发性泪腺导管腺癌是一种罕见的泪腺肿瘤。泪腺导管腺癌的表现可能包括边界清楚的囊性病变，提示存在不同的亚型。各种治疗选择适用于不同亚型的泪腺导管腺癌。
