Periorbital squamous cell carcinoma with simultaneous adenocarcinoma in the right orbit

INTRODUCTION: Cutaneous squamous cell carcinoma (cSCC) is an invasive and malignant tumour that is common in the orbital region. However, adenocarcinoma of the lacrimal gland has an incidence of less than one case per million per year. We present a patient who experienced a cSCC and adenocarcinoma of the lacrimal gland, which is unusual for both these cancers to present in the same patient in such close proximity. PRESENTATION OF CASE: A 47-year old male patient was referred for management of a cSCC of the right upper eyelid. This was treated surgically by means of wide local excision and orbital exenteration. Histological analysis of the resection specimen found an incidental synchronous lacrimal gland adenocarcinoma. To our knowledge this is the first case report to describe this phenomenon. DISCUSSION: Although SCC is the most common secondary epithelial neoplasms of the orbit region, adenocarcinomas are rare in this same region. Currently, when performing a literature search, there has been no cases found that documents a poorly differentiated cSCC with a synchronous adenocarcinoma of the lacrimal gland. This is mainly because there are improved facilities and accessible healthcare. This report will mainly focus on the presentation and management of this patient case. CONCLUSION: To our knowledge this is the first case report documenting a poorly differentiated cSCC and a synchronous adenocarcinoma of the lacrimal gland. Our case report raises the awareness of the possibility of patients with synchronous tumours and is a valuable addition to the literature.