Primary ductal adenocarcinoma of the lacrimal gland: case report

Primary ductal adenocarcinoma of the lacrimal gland: case report

Alternative title Adenocarcinoma ductal primário da glândula lacrimal: relato de caso
Author Damasceno, Renato Wendell Ferreira Autor UNIFESP Google Scholar
Holbach, Leonard M. Google Scholar
Institution Univ Erlangen Nurnberg
Universidade Federal de São Paulo (UNIFESP)
Abstract A 78-year-old male patient presented with double vision, painless palpable mass under the right superolateral orbital rim, downward displacement and restricted adduction of the right eye. His visual acuity was 20/50 OD and 20/20 OS. Hertel exophthalmometry was 21 mm OD and 17 mm OS. Computed tomographic scans showed an infiltrative orbital mass with ill-defined, irregular margins, involving the lacrimal gland and the lateral rectus muscle. The patient underwent an anterior transcutaneous transseptal orbitotomy with incisional biopsy and surgical debulking. Histopathologic evaluation revealed primary ductal adenocarcinoma of the lacrimal gland. Following the metastatic work up, he underwent an eyelid-sparing orbital exenteration. Microscopically, the tumor elements were characterized by large polygonal cells with vesicular nuclei, prominent nucleoli and amphophilic cytoplasm. The tumor components comprised duct-type structures with papillary and cribriform patterns, surrounded by prominent basement membrane. The tumor cells were positive for cytokeratin-7, matrix metalloproteinase (MMP)-2, MMP-9, MMP-13 and proto-oncogene Her-2/neu, but negative for cytokeratin-5, cytokeratin-20, p63, prostate-specific antigen, S-100 protein and thyroid transcription factor. These histopathologic findings were compatible with poorly differentiated ductal adenocarcinoma of the lacrimal gland, T3N0M0. Twenty-four months after orbital exenteration, the patient was diagnosed with ipsilateral parotid gland and cervical lymph node metastases and died of disease.
Keywords Lacrimal gland/pathology
Adenocarcinoma/surgery
Matrix metalloproteinase 2
Matrix metalloproteinase 9
Matrix metalloproteinase 13
Case reports
Language English
Date 2012-01-01
Published in Arquivos Brasileiros De Oftalmologia. Sao Paulo: Consel Brasil Oftalmologia, v. 75, n. 1, p. 64-66, 2012.
ISSN 0004-2749 (Sherpa/Romeo, impact factor)
Publisher Consel Brasil Oftalmologia
Extent 64-66
Origin http://dx.doi.org/10.1590/S0004-27492012000100014
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000303444800014
SciELO ID S0004-27492012000100014 (statistics in SciELO)
URI http://repositorio.unifesp.br/11600/42719

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