De novo adenocarcinoma of the lacrimal gland: Case report

Adenocarcinoma of the lacrimal gland is an epithelial malignancy with an incidence according to the literature of 5–7%. It is clinically revealed by an upper palpebral mass often associated with an inflammatory exophthalmos. It is a high-grade malignancy and there are no pathognomonic clinical or radiological signs. The Core 14G needle biopsy technique is now the simplest procedure to remove tissue from the mass to be analyzed. This allows a precise histological and immunohistochemical study, to establish a diagnosis of certainty and to institute a rapid and adequate therapeutic management in order to improve the prognosis. We report the case of a de novo lacrimal gland adenocarcinoma diagnosed in a 55-year-old patient. The patient presented with a subpalpebral mass, located in the superior-external angle of the globe, which was very inflammatory. The radiological work-up revealed a left intra-orbital tumor process, extra-conical, developed at the expense of the lacrimal gland, in contact with the external wall of the orbit with local cortical effractions. The anatomopathological examination of the specimen obtained by Core 14G needle biopsy, under local anesthesia and on an outpatient basis, was in favor of a moderately differentiated and infiltrating adenocarcinoma of the lacrimal gland. The extension workup did not reveal a metastatic focus. A total exenteration was performed with complementary postoperative radiotherapy. The patient was followed up after 2 years without recurrence.