Pleomorphic adenoma of the lacrimal gland

Case contributed by Frank Gaillard

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

MRI through the orbits demonstrates an extraconal mass in the upper outer quadrant of the left orbit which is of intermediate T1 and T2 signal, and enhances brightly following administration of contrast. 

The mass is pushing the globe inferomedially and importantly is distorting the globe (best seen on coronal image) which indicates the mass is firm. 

Features are strongly suggestive of a lacrimal gland tumor and pleomorphic adenoma is the most likely entity. 

Case Discussion

Differential includes:

  • lacrimal gland tumors
  • nerve sheath tumors
  • metastases: usually less well defined
  • lymphoma: usually softer (do not distort the globe)
  • orbital hemangioma: more commonly intraconal

Pleomorphic adenoma of the lacrimal gland was histologically proven on resection. 

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