Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass

Renu Bansal; Viji Rangarajan; Radhakrishnan Shanthi; Kavitha

doi:doi:10.11648/j.cmr.20221103.13

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Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass

Renu Bansal, Viji Rangarajan, Radhakrishnan Shanthi, Kavitha

Published in Clinical Medicine Research (Volume 11, Issue 3)

Received: 14 October 2021 Accepted: 14 December 2021 Published: 8 June 2022

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Abstract

Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.

Published in	Clinical Medicine Research (Volume 11, Issue 3)
DOI	10.11648/j.cmr.20221103.13
Page(s)	48-52
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Orbit Tumors, Lacrimal Gland Mass, Proptosis

References

[1]	Lin YH, Huang SM, Yap WK, Yang JW, Yeung L, Tsan DL, Chang JT, Chen LC. Outcomes in patients with lacrimal gland carcinoma treated with definitive radiotherapy or eye-sparing surgery followed by adjuvant radiotherapy. Radiat Oncol. 2020 Jun 22; 15 (1): 156. doi: 10.1186/s13014-020-01601-8. PMID: 32571366; PMCID: PMC7310012.
[2]	Bernardini FP, Devoto MH, Croxatto JO. Epithelial tumors of the lacrimal gland: an update. Curr Opin Ophthalmol. 2008 Sep; 19 (5): 409-13. doi: 10.1097/ICU.0b013e32830b13e1. PMID: 18772674.
[3]	Dr Suguna Belur Venogopal, Dr Sneha Ashok Motwani, Dr Sruthi Prasad, Dr Geethamani V. Lacrimal gland Neoplasms: A 10 Year Retrospective. JMSCR. 2020 Jan; 08 (01). https://dx.doi.org/10.18535/jmscr/v8i1.03.
[4]	Huang, S., Juniat, V., Satchi, K. et al. Bilateral lacrimal gland disease: clinical features and outcomes. Eye (2021). https://doi.org/10.1038/s41433-021-01819-0
[5]	Tang X, Zhang C, Chen R, Zhou X, Zhang Y. Treatment of adenoid cystic carcinoma of the mobile tongue with anterolateral thigh flap reconstruction: A case report. Medicine (Baltimore). 2019 Apr; 98 (16): e15250. doi: 10.1097/MD.0000000000015250. PMID: 31008961; PMCID: PMC6494219.
[6]	Eckardt, A. M., Lemound, J., Rana, M. et al. Orbital lymphoma: diagnostic approach and treatment outcome. World J Surg Onc 11, 73 (2013). https://doi.org/10.1186/1477-7819-11-73
[7]	Strianese D, Elefante A, Matarazzo F, Panico A, Ferrara M, Tranfa F: Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma. Case Rep Ophthalmol 2013; 4: 109-113. doi: 10.1159/000354963.
[8]	Shields JA, Shields CL, Eagle RC, Freire JE, Mercado GV, Schnall B. Adenoid Cystic Carcinoma of the Lacrimal Gland Simulating a Dermoid Cyst in a 9-Year-Old Boy. Arch Ophthalmol. 1998; 116 (12): 1673–1676. doi: 10.1001/archopht.116.12.1673.
[9]	Misra, N., Gupta, A., Bhardwaj, I. et al. Hemangioendothelioma of orbit. Indian J Otolaryngol Head Neck Surg 51, 23–26 (1999). https://doi.org/10.1007/BF03022709
[10]	Jamshidian-Tehrani M, Eshraghi B, Zarei M, Nozarian Z, Rafizadeh S, M, Ghadimi H: Successful Total Resection of an Orbital Epithelioid Hemangioendothelioma with the Aid of Endovascular Embolization. Ocul Oncol Pathol 2019; 5: 50-53. doi: 10.1159/000489126.
[11]	Nigel G. Rawlings, Seymour Brownstein, Jennifer W. Robinson, David R. Jordan, Orbital schwannoma: histopathologic correlation with magnetic resonance imaging, Canadian Journal of Ophthalmology, Volume 42, Issue 2, 2007, Pages 326-328, ISSN 0008-4182, https://doi.org/10.3129/can.j.ophthalmol.i07-016.
[12]	Islam MN, Amin MS, Dipi RM, Khan NA. Comparison of computed tomographic and cytopathological findings in the evaluation of adult orbital mass. Mymensingh Medical Journal: MMJ. 2013 Jan; 22 (1): 75-79.
[13]	von Holstein, S. L., Coupland, S. E., Briscoe, D., Le Tourneau, C. and Heegaard, S. (2013), Epithelial tumours of the lacrimal gland: a clinical, histopathological, surgical and oncological survey. Acta Ophthalmologica, 91: 195-206. https://doi.org/10.1111/j.1755-3768.2012.02402.x
[14]	Yadav BS, Sharma SC. Orbital lymphoma: role of radiation. Indian J Ophthalmol 2009; 57 (2): 91–97.
[15]	Grant H. Moore & Daniel B. Rootman. Orbital inflammatory disease management. Expert Review of Ophthalmology. 2016; 11 (6), 415-428. https://doi.org/10.1080/17469899.2016.1233399.

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APA Style

Renu Bansal, Viji Rangarajan, Radhakrishnan Shanthi, Kavitha. (2022). Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clinical Medicine Research, 11(3), 48-52. https://doi.org/10.11648/j.cmr.20221103.13

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ACS Style

Renu Bansal; Viji Rangarajan; Radhakrishnan Shanthi; Kavitha. Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clin. Med. Res. 2022, 11(3), 48-52. doi: 10.11648/j.cmr.20221103.13

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AMA Style

Renu Bansal, Viji Rangarajan, Radhakrishnan Shanthi, Kavitha. Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clin Med Res. 2022;11(3):48-52. doi: 10.11648/j.cmr.20221103.13

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@article{10.11648/j.cmr.20221103.13,
  author = {Renu Bansal and Viji Rangarajan and Radhakrishnan Shanthi and Kavitha},
  title = {Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {48-52},
  doi = {10.11648/j.cmr.20221103.13},
  url = {https://doi.org/10.11648/j.cmr.20221103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.13},
  abstract = {Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.},
 year = {2022}
}

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TY  - JOUR
T1  - Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass
AU  - Renu Bansal
AU  - Viji Rangarajan
AU  - Radhakrishnan Shanthi
AU  - Kavitha
Y1  - 2022/06/08
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.13
DO  - 10.11648/j.cmr.20221103.13
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 48
EP  - 52
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.13
AB  - Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.
VL  - 11
IS  - 3
ER  -

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Author Information

Renu Bansal

Department of Orbit and Oculoplastic, Aravind Eye Hospital, Coimbatore, India
Viji Rangarajan

Department of Orbit and Oculoplastic, Aravind Eye Hospital, Coimbatore, India
Radhakrishnan Shanthi

Department of Pathology, Aravind Eye Hospital, Madurai, India
Kavitha

Department of Orbit and Oculoplastic, Aravind Eye Hospital, Coimbatore, India

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Plain Text BibTeX RIS

APA Style

Renu Bansal, Viji Rangarajan, Radhakrishnan Shanthi, Kavitha. (2022). Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clinical Medicine Research, 11(3), 48-52. https://doi.org/10.11648/j.cmr.20221103.13

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ACS Style

Renu Bansal; Viji Rangarajan; Radhakrishnan Shanthi; Kavitha. Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clin. Med. Res. 2022, 11(3), 48-52. doi: 10.11648/j.cmr.20221103.13

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AMA Style

Renu Bansal, Viji Rangarajan, Radhakrishnan Shanthi, Kavitha. Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass. Clin Med Res. 2022;11(3):48-52. doi: 10.11648/j.cmr.20221103.13

Copy | Download

@article{10.11648/j.cmr.20221103.13,
  author = {Renu Bansal and Viji Rangarajan and Radhakrishnan Shanthi and Kavitha},
  title = {Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {48-52},
  doi = {10.11648/j.cmr.20221103.13},
  url = {https://doi.org/10.11648/j.cmr.20221103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.13},
  abstract = {Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass
AU  - Renu Bansal
AU  - Viji Rangarajan
AU  - Radhakrishnan Shanthi
AU  - Kavitha
Y1  - 2022/06/08
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.13
DO  - 10.11648/j.cmr.20221103.13
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 48
EP  - 52
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.13
AB  - Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.
VL  - 11
IS  - 3
ER  -

Copy | Download