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Adenoid Cystic Carcinoma of the Lacrimal Gland Simulating a Dermoid Cyst in a 9-Year-Old Boy
Arch Ophthalmol. 1998;116:1673-1676.
Adenoid cystic carcinoma of the lacrimal gland is a malignant neoplasm that is generally found in adults and is usually managed by orbital exenteration and supplemental external beam irradiation or chemotherapy. A recent report has suggested that the tumor may have a less malignant course in children. We describe a case of adenoid cystic carcinoma of the lacrimal gland that simulated a dermoid cyst clinically and radiographically in a 9-year-old boy. The patient was treated with local surgical resection of the mass, followed by orbital plaque brachytherapy. Based on a review of the literature and our recent experience, the advisability of a more conservative approach to this tumor in selected cases is discussed. Although no prognostic conclusions can be drawn on the basis of a single case report with short follow-up, the relatively earlier detection of this tumor made possible by modern orbital imaging studies may allow total removal at an earlier stage and prevent orbital exenteration in a patient with normal vision. Recent developments suggest that there may be a basis for reassessing the advisability of a radical approach to the management of adenoid cystic carcinoma of the lacrimal gland in selected cases.
Jerry A. Shields, MD;
Carol L. Shields, MD;
Ralph C. Eagle, Jr, MD;
Jorge E. Freire, MD;
Gary V. Mercado, MD;
Bruce Schnall, MD
From the Oncology Service (Drs J. Shields, C. Shields, and Mercado), the Pathology Department (Dr Eagle) and the Pediatric Ophthalmology Department (Dr Schnall), Wills Eye Hospital, Thomas Jefferson University; and the Department of Radiation Oncology, Allegheny University (Dr Freire); Philadelphia, Pa.
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