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Adenocarcinoma of the lacrimal gland: a case report
© The Author(s). 2017
Received: 20 January 2017
Accepted: 2 August 2017
Published: 11 September 2017
Primary ductal adenocarcinomas of the lacrimal gland are very rare. This neoplasm shares some histological and immunohistochemical similarities with salivary duct carcinoma.
Here, we present a case of a 55-year-old Moroccan man with lacrimal gland adenocarcinoma. He underwent orbital exenteration with lymph nodes dissection and ipsilateral parotidectomy. After surgery, he was lost to follow-up and died 13 months later.
Lacrimal gland tumors are rare but highly aggressive salivary gland tumors. Complete excision with adjuvant radiotherapy is recommended.
Malignant epithelial tumors of the lacrimal gland are rare and constitute less than 5% of all biopsied orbital lesions . Primary ductal adenocarcinomas of the lacrimal gland are very rare, accounting for only 5 to 7% of epithelial tumors of the lacrimal gland . They are often classified according to the histologic classification of salivary gland tumors because of their morphopathological similarities [1–4]. Primary ductal adenocarcinoma is generally regarded as an aggressive malignancy; however, the best treatment and overall prognosis are unknown , which may suggest that primary ductal adenocarcinoma of the lacrimal gland has a poor prognosis . Here, we report a case of adenocarcinoma of the lacrimal gland with a review of the literature.
Tumors of the lacrimal gland constitute less than 5% of all biopsied orbital lesions [3, 4]. The most common epithelial malignancy is primary adenoid cystic carcinoma; adenocarcinoma is rare, representing only 5 to 7% of epithelial tumors of the lacrimal gland [2–6]. Because there is no specific histopathologic classification for lacrimal gland tumors, they are often classified according to the histological classification of salivary gland tumors with which they share many similarities [1, 3, 7].
This subtype of lacrimal gland, adenocarcinoma, was described for the first time in 1996 by Katz et al. . Since then, most reports in the literature are case reports describing an aggressive clinical pattern and poor prognosis [1, 2, 8].
The patient’s short life expectancy after surgical treatment for adenocarcinoma is due to the early tendency of these tumors for lymphatic invasion and dissemination in the nasal cavity, paranasal sinuses, and more generally in the cranio-orbital region [2, 4].
The tumor is very aggressive [1, 8] with an early affinity for local and distant metastasis and high rates of local recurrences [2, 3]. The death rate of these tumors is approximately 70%, and it usually occurs 2 to 3 years after the initial appearance of the tumor . The most common sites of metastasis are the lung, the bones, the liver, and the brain [2, 6].
The purpose of the treatment is early locoregional control. Complete excision with adjuvant radiotherapy is recommended [3, 4]. Regional lymph node involvement should be methodically evaluated; regional lymph node dissection and/or radiotherapy should be undertaken even in the absence of palpable lymphadenopathy .
It is well known that the lacrimal glands can develop aggressive tumors, primary adenocarcinoma for example. Due to the lack of data on this condition, the clinical behavior, prognosis, and treatment of these tumors are still poorly defined. Early recognition of this highly aggressive tumor ultimately may help to delineate its management.
All the authors are thankful for the provision of the necessary facilities for the preparation of the manuscript.
Special thanks are due to the Faculty of Medicine and Pharmacy of Rabat; the source(s) of funding for all the authors.
Availability of data and materials
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
AT examined the patient, participated in the sequence alignment, and drafted the manuscript. MM carried out histological study of the lacrimal gland. SE, YE, and AT participated in the sequence alignment. TK helped to draft the manuscript. NB coordinated between departments, and revised and helped to draft the article. All authors read and approved the final manuscript.
Ethics approval and consent to participate
Consent for publication
Written informed consent was obtained from the patient's son for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
The authors declare that they have no competing interests.
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