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Atypical presentation of lacrimal gland pleomorphic adenoma with necrotic foci
Presentación atípica de un adenoma pleomorfo de la glándula lagrimal con focos de necrosis
A. Casado
, V. Sánchez-Gutiérrez, C. Barrancos, A. Albandea
Corresponding author
Departamento de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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"apellidos" => "Valor" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669114004201" "doi" => "10.1016/j.oftal.2014.12.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669114004201?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579415001784?idApp=UINPBA00004N" "url" => "/21735794/0000009000000009/v1_201512030104/S2173579415001784/v1_201512030104/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Atypical presentation of lacrimal gland pleomorphic adenoma with necrotic foci" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "432" "paginaFinal" => "434" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Casado, V. Sánchez-Gutiérrez, C. Barrancos, A. Albandea" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Casado" "email" => array:1 [ 0 => "casadorojo@hotmail.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Sánchez-Gutiérrez" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Barrancos" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Albandea" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Presentación atípica de un adenoma pleomorfo de la glándula lagrimal con focos de necrosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1131 "Ancho" => 2169 "Tamanyo" => 295427 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Image of acute episode that shows inflammation of the lacrimal gland, left upper eyelid shaped like an italic “<span class="elsevierStyleItalic">S</span>” and mild proptosis with conjunctival chemosis and hyperemia. (B) A week later, there were no signs of inflammation. (C) The computed tomography with contrast material shows the tumour and a peripheral increase. (D) Necrosis in the inner part of the pleomorphic adenoma (haematoxylin and eosin; magnification ×200).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pleomorphic adenomas of the lacrimal gland normally present as painless masses in the external upper quadrant of the orbit. However, the presence of this tumour should be suspected if there is a growth in said location, regardless of its presentation form.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There was a case of a patient with a mass in the lacrimal gland that was discovered after an apparent dacryoadenitis. It was decided to remove the mass because it was suspected to be a dacryops, and the histological study described the presence of a pleomorphic adenoma in the lacrimal gland with multiple necrosis foci.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinical case</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 48-year old male patient who attended a consultation due to intense, continuous pain in the external upper quadrant of the left orbit, associated with inflammation of the ipsilateral lacrimal gland (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). He did not present associated fever, and a systemic assessment conducted to rule out the presence of autoimmune diseases presented normal results. He did not have diabetes and was not a smoker. In the physical examination, the patient presented a deformity in the left upper eyelid shaped like an italic “<span class="elsevierStyleItalic">S</span>” and mild proptosis, painful on palpation. Moreover, conjunctival chemosis was observed in the temporal area associated with moderate conjunctival hyperemia.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">After a week of treatment with oral antibiotics and anti-inflammatory drugs, the symptoms improved, but the deformity in the upper eyelid and proptosis persisted (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). On palpation, the lacrimal gland was enlarged, with cyst characteristics, with mobility, and not adhered to deep planes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The orbital tomography showed the presence of a tumour adjacent to the left lacrimal gland, with well-defined borders and with peripheral increase after the administration of contrast material (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). These findings were described as compatible with a dermoid cyst.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Under local anaesthesia and sedation, the patient underwent the removal of the lesion and the adjacent lacrimal gland using a transseptal approach (anterior orbitotomy). The sample underwent an anatomopathological study, which reported the presence of a pleomorphic adenoma with multiple necrosis foci (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D).</p><p id="par0035" class="elsevierStylePara elsevierViewall">After a 3-year follow-up with serial tomographies and magnetic resonance imaging tests (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), no signs of tumour recurrence or progression were observed, and the patient did not present any pain or discomfort.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">The lacrimal gland may grow due to several aetiologies. The presence of pain is a symptom that may contribute to the differential diagnosis. Usually, painless lacrimal gland tumours include the following: pleomorphic adenomas (the most common benign tumours of the lacrimal gland<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a>), sarcoidosis, lymphomas and dermoid cysts. On the other hand, the aetiologies that should be suspected of if there is a tumour in said location associated with pain are the following: cystic adenoid carcinoma, orbital inflammatory pseudotumour and acute dacryoadenitis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> Nevertheless, abiding by this classification may lead to mistakes. Prabhakaran et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> published that 22% of patients who present a mass in the lacrimal gland are wrongly diagnosed with pleomorphic adenomas when they actually present another of the above-mentioned aetiologies, even if imaging tests were conducted. Therefore, it is essential to conduct a thorough anatomopathological study to obtain a correct diagnosis and not to overlook malignancy signs. Moreover, given that the diagnosis of this tumour in this location is complicated even when imaging tests are performed, it is recommended to remove the intact tumour, without prior biopsy and without capsule rupture, so as to avoid the expansion of the tumour.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This case shows that the presentation form of tumours in this location may lead to confusion in the differential diagnosis, given that pleomorphic adenomas usually do not present pain. However, in this case, this presentation form may be related to necrosis foci found in the histological study.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Besides, in the lacrimal gland, pleomorphic adenomas may be located in other glands, such as salivary glands. It is in these glands that pleomorphic adenomas with necrosis are described.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> Interestingly, as in the case presented, these adenomas with necrosis in these major and minor salivary glands had clinical symptoms of pain upon presentation. The necrosis in the described cases was secondary to a fine-needle puncture-aspiration biopsy, although it occurred spontaneously in other cases.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The presence of necrosis in a tumour is usually a sign of bad prognosis, given that a malignant tumour has a growth rate faster than that of blood vessels, which results in necrosis. Nevertheless, in the case described, no signs of malignancy were observed, and the necrosis could be due to vascular compression ischaemia. Also, the uncommon appearance of the tumour in the tomography may be due to this necrosis.</p><p id="par0060" class="elsevierStylePara elsevierViewall">After reviewing the literature, we believe that this is the first case of necrotic pleomorphic adenoma in the lacrimal gland. This finding is consistent with the fact that this tumour was described in salivary glands and that, in these cases, the presentation is painful. Furthermore, we believe that this case may help to identify these necrotic tumours with a painful presentation form, an uncommon tomography and a histological examination of a benign tumour with necrosis that may confuse the pathologist.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres584991" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec600910" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres584990" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec600911" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-06-11" "fechaAceptado" => "2015-02-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec600910" "palabras" => array:6 [ 0 => "Pleomorphic adenoma" 1 => "Lacrimal gland" 2 => "Necrosis" 3 => "Painful mass" 4 => "Dacryops" 5 => "Salivary glands" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec600911" "palabras" => array:6 [ 0 => "Adenoma pleomorfo" 1 => "Glándula lagrimal" 2 => "Necrosis" 3 => "Dolor" 4 => "Dacriops" 5 => "Glándulas salivares" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The case is presented of 48 year-old male complaining of a painful left upper eyelid and swelling of the lacrimal gland, with a suspicion of dacryoadenitis. Removal was decided after dacriops suspicion. Histopathology diagnosed a pleomorphic adenoma of the lacrimal gland, with areas of necrosis.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Lacrimal gland pleomorphic adenoma usually presents as a slowly progressive painless mass. However, painful presentation in this case might be related with necrotic foci found in the histopathological examination. Although not described in lacrimal glands, pleomorphic adenomas have already been reported in the major and minor salivary glands, and these patients also presented with a painful mass.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Varón de 48 años que acude por dolor en región periorbitaria superior izquierda, con sospecha de dacrioadenitis. Tras mejoría clínica y sospecha de dacriops se decide extirpar dicha lesión. La anatomía patológica diagnostica un adenoma pleomorfo de la glándula lagrimal con áreas de necrosis.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La forma de presentación de un adenoma pleomorfo suele ser asintomática. Sin embargo, la presencia de dolor en este caso puede estar relacionada con la necrosis observada en el estudio histológico. Aunque no está descrito en glándulas lagrimales, sí que existen referencias de necrosis de adenomas pleomorfos de glándulas salivares con dolor en la presentación.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Casado A, Sánchez-Gutiérrez V, Barrancos C, Albandea A. Presentación atípica de un adenoma pleomorfo de la glándula lagrimal con focos de necrosis. Arch Soc Esp Oftalmol. 2015;90:432–434.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Paper presented as “Atypical presentation of a pleomorphic adenoma of the lacrimal gland” at the XXXII Annual Meeting of the ESOPRS (European Society Of Ophthalmic Plastic And Reconstructive Surgery), 19–21 September 2013.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1131 "Ancho" => 2169 "Tamanyo" => 295427 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Image of acute episode that shows inflammation of the lacrimal gland, left upper eyelid shaped like an italic “<span class="elsevierStyleItalic">S</span>” and mild proptosis with conjunctival chemosis and hyperemia. (B) A week later, there were no signs of inflammation. (C) The computed tomography with contrast material shows the tumour and a peripheral increase. (D) Necrosis in the inner part of the pleomorphic adenoma (haematoxylin and eosin; magnification ×200).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1973 "Ancho" => 1168 "Tamanyo" => 118861 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Frontal section of nuclear magnetic resonance imaging (NMRI) in T1 weighted sequence one year after the removal of the pleomorphic adenoma. No signs of recurrence were observed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histopathological classification of 272 primary epithelial tumors of the lacrimal gland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Ni" 1 => "P.K. Kuo" 2 => "T.P. Dryja" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chin Med J" "fecha" => "1992" "volumen" => "105" "paginaInicial" => "481" "paginaFinal" => "485" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1333391" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pleomorphic adenoma of the lacrimal gland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.E. Rose" 1 => "J.E. Wright" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Ophthalmol" "fecha" => "1992" "volumen" => "76" "paginaInicial" => "395" "paginaFinal" => "400" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1320923" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lesions mimicking lacrimal gland pleomorphic adenoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.C. Prabhakaran" 1 => "P.S. Cannon" 2 => "A. McNab" 3 => "G. Davis" 4 => "B. O’Donnell" 5 => "P.J. Dolman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bjo.2008.156307" "Revista" => array:6 [ "tituloSerie" => "Br J Ophthalmol" "fecha" => "2010" "volumen" => "94" "paginaInicial" => "1509" "paginaFinal" => "1512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20962353" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Necrosis in benign salivary gland neoplasms. Not necessarily a sign of malignant transformation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Allen" 1 => "D. Damm" 2 => "B. Neville" 3 => "B. Rodu" 4 => "D. Page" 5 => "D.R. Weathers" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Oral Surg Oral Med Oral Pathol" "fecha" => "1994" "volumen" => "78" "paginaInicial" => "455" "paginaFinal" => "461" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7800377" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009000000009/v1_201512030104/S217357941500184X/v1_201512030104/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009000000009/v1_201512030104/S217357941500184X/v1_201512030104/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941500184X?idApp=UINPBA00004N" ]
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