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Adenoid cystic carcinoma of the lacrimal gland - recurrence

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Right proptosis. Had surgery for periorbital mass 2 years ago.

Patient Data

Age: 55 years
Gender: Male

Well-circumscribed lobulated right orbital extraconal soft tissue mass centered on the lacrimal fossa with intraconal extension compressing and displacing the orbital muscles, optic nerve and the ocular globe with proptosis grade 2. It displays a low signal on T1, and a high signal on T2 and FLAIR with vivid heterogeneous enhancement. No calcification or hemorrhagic component is seen on the GE sequence. There is a lateral extra orbital extension infiltrating the temporalis muscle as well as a posterior extension infiltrating the greater sphenoid wing with an extradural mass of the anterior aspect of the middle cranial fossa extending to the ipsilateral cavernous sinus.

Small vessel ischemic changes are noted in the frontal and parietal lobes.

Case Discussion

MRI features of a lacrimal tumor (recurrence) with intraconal and intracranial extension in a patient known for lacrimal adenoid cystic carcinoma operated 2 years prior.

Adenoid cystic carcinoma is the most common malignant lacrimal gland tumor and accounts for 50% of malignant tumors of lacrimal gland and 25% of all lacrimal gland tumors.

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