Pleomorphic adenoma of lacrimal gland
A 62-year-old male patient referred to our clinic due to painless exophthalmia of his right eye for the last 2 years. On neurological examination of the patient, there was no abnormality except for the up-gaze restriction and severe exophthalmia. Computerized tomography revealed an intraorbital mass in the right eye. A well-defined 2.5-cm isodense mass was located on the right lacrimal gland. The mass was contrasted homogenously (Fig. a and b). Cranial magnetic resonance imaging (MRI) revealed an isointense mass on the superolateral part of right orbita in the coronal intersections and it was contrasted homogenously (Fig. a and b). The existing score of our patient according to Rose and Wright was +8 points. Combined orbitofrontal craniotomy was performed through a transcranial approach. The well-defined, soft, white, 2.5-cm mass was removed completely. Exophthalmoses disappeared after the surgery (Fig. a and b). Histological examination of the surgical specimen covered the epithelial and stromal components that formed the glandular structures. Keratinized plugs were seen in some glandular lumens. Cartilaginous differentiation of stroma was found (Fig. a–d). Based on these findings, the tumor was diagnosed as pleomorphic adenoma. There was no recurrence after 8-year clinical follow-up.