Adenoid cystic carcinoma (ACC) of the lacrimal glands is an extraconal malignancy usually originating from the orbital lobe of the lacrimal gland.
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Clinical presentation
It often presents with orbital pain and paresthesia, since this type of tumor is frequently associated with perineural spreading. The tumor is highly aggressive and has a poor prognosis and high recurrence rate 3.
Radiographic features
CT
CT may show an infiltrative mass involving the lacrimal gland, very often associated with bony destruction, showing enhancement after contrast administration.
MRI
Signal characteristics include:
T1: homogeneously hypointense
T2: usually isointense, but sometimes hypointense (basaloid subtype)
T1 C+ (Gd): moderate enhancement
Differential diagnosis
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inflammatory mass associated with
non-Hodgkin lymphoma
other neoplasms: pleomorphic adenoma (benign), squamous cell carcinoma, mucoepidermoid carcinoma