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Case: A Haitian woman with a chronic ocular condition presents to a clinic run by the Good Shepherd Foundation. Her condition is debilitating, cosmetically disfiguring, and frightening to the patient and observers. The patient is having problems with depth perception and ocular infections.

Pleomorphic Adenoma

Photo Credit: Alfredo Gonzalez, DNP

Diagnosis:

This patient has pleomorphic adenoma.

Pleomorphic adenoma is a common epithelial tumor; however, the giant pleomorphic adenoma depicted in the photograph is rare. The incidence of pleomorphic adenomas is prevalent between the third and sixth decades of life. There are 4 types of pleomorphic adenomas affecting lacrimal glands: inflammatory, lymphoid, metastatic, and primary epithelial tumors. Benign pleomorphic adenoma tumors can become malignant in time or following multiple surgical interventions. Patients with pleomorphic adenomas may retain extraocular movement and be able to see light.

Clinical Practice Pearls:

  • Diagnostic studies include CT and MRI.

  • Biopsy is discouraged.

  • Treatment options: surgical intervention is the gold standard of care.

  • A multidisciplinary treatment approach can be beneficial.

  • Collaboration among specialties improves the chance for a successful treatment.

Additional Reading:

  1. Goldberg RA, Rootman DB, Nassiri N, et al. And Shadpour JM. Orbital tumor excision without bony marginotomy under local and general anesthesia. J Ophthalmol. 2014;2014:424852.
     
  2. Holliday EB, Esmaeli B, Pinckard J, et al. A multidisciplinary orbit-sparing treatment approach that includes proton therapy for epithelial tumors of the orbit and ocular adnexa. Int J Radiat Oncol Biol Phys. 2016;95(1):344-352.
     
  3. Perez D, Pires F, Almeida O, et al. Epithelial lacrimal gland tumor: a clinicopathological study of 18 cases. Otolaryngol Head Neck Surg. 2006;134(2):321-325.

 

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Last Modified: 10/19/2017
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