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Long-Standing Pleomorphic Adenoma Coexisting With an Orbital Epithelial Inclusion Cyst

Bothra, Nandini M.D.

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Ophthalmic Plastic and Reconstructive Surgery: May/June 2022 - Volume 38 - Issue 3 - p e93
doi: 10.1097/IOP.0000000000002129
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A 38-year-old gentleman presented with complaints of painless, inferior dystopia of the right eye of 1-year duration. On examination, the right eye had a mass lesion in the superior orbit, firm on palpation, non-tender resulting in a 6-mm inferior dystopia (Fig. A). Extraocular motility showed restriction in elevation due to the mass effect. On eversion of the upper eyelid, superior fornecial prolapse was noted. Computed tomography image axial cut showed a dumbbell shaped heterogenous, well-defined mass in the superotemporal orbit (Fig. B). The sagittal cuts delineated an anterior mass lesion, which was heterogenous and well-defined and was separate from a posteriorly located well-defined cystic lesion (Fig. C). Exploration of the orbit showed a well-defined 2 × 2 cm well-defined mass lesion arising from the lacrimal gland (Fig. D) and an underlying cystic lesion within the orbit (Fig. E). Histopathology showed a well-encapsulated tumor with proliferation of epithelial and myoepithelial cells, arranged in acini, cribriform, and trabecular pattern with keratin pearl formation suggestive of pleomorphic adenoma and another lesion with luminal wall lined by columnar to cuboidal epithelium with apical snouts projecting into the lumen suggestive of an epithelial inclusion cyst.

Long-standing pleomorphic adenoma with an orbital epithelial inclusion cyst.
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