Year : 1975 | Volume
: 23 | Issue : 4 | Page : 38--39
Pleomorphic adenoma of Krause's gland
Rangaraya Medical College, Kakinada, India
Rangaraya Medical College, Kakinada
|How to cite this article:|
Venkataramayya K. Pleomorphic adenoma of Krause's gland.Indian J Ophthalmol 1975;23:38-39
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Venkataramayya K. Pleomorphic adenoma of Krause's gland. Indian J Ophthalmol [serial online] 1975 [cited 2013 May 22 ];23:38-39
Available from: http://www.ijo.in/text.asp?1975/23/4/38/31440
Tumours of Krause's gland are very rare indeed, although tumours of lacrimal glands were reported not infrequently. Mixed tumours of lacrimal gland occur usually between 20 and 40 years of age.,, Histologically tumour shows a mixed origin part-fibrinous, partcartilagenous and part-adenocarcinomatous.
A case report of pleomorphic adenoma of accessory lacrimal gland is described below.
A male patient aged about 30 years attended the ophthalmic department of the Government General Hospital, Kakinada on with a complaint of a swelling in the right upper eyelid, of 3 years duration. It started as a small swelling of the size of a small seed in the right eye under the upper eye lid, which has gradually increased and attained the present size. There was no history of trauma, pain defective vision or redness in that eye.
General examination shooed no abnormality. Local examination showed a sub-conjunctival swelling in the right eye in the upper temporal region which was oval in shape and of size 2½" x 1" extending obliquely into the upper fornix [Figure 1]. On palpation. the swelling was not attached to the lacrimal gland. Swelling was moving with the conjunctiva. Slight congestion was present over the swelling, but there was no vascularity. Consistency was hard in some areas and firm in other areas. There was no tenderness.
Remaining structures were normal. Visual acuity was 6/6. Fundus was normal. Intra-ocular tension was normal. Ocular movements were full. There was no proptosis or regional lymph adenopathy. Left eye was normal.
Other investigations were non-contributory.
The tumour was excised completely under local anaesthesia and sent for histo-pathological examination. Post-operative period was uneventful. Pathological examination showed the appearance of pleomorphic adenoma showing uniform type of cells arranged in solid sheets and glandular pattern (marked X in [Figure 2]) with myxomatous stroma resembling cartilage (marked `0' in [Figure 2]) No recurrence is noted in the follow up of one year.
Krause's glands are situated in the conjunctiva near the fornices. There are about 20 glands in the region of upper eye lid, and about 8 glands in the region of lower lid. Their histological structure is same as that of lacrimal gland. Pleomorphic adenoma shows both epithelial and mesenchymal elements. These are otherwise called mixed tumours. In this there are two types of tumours benign and malignant. Benign type is more common. It is not metastatogenic. But if it recurs, the tumour may develop malignant cytology and then become frank carcinoma. Malignant type shows areas of frank malignancy and they metastatise. Two cases of plemorphic adenomata, one under the upper eye lid and another in the lower fornix were reported. A probable origin from the accessory lacrimal gland of Krause was postulated. The above described case may be a pleomorphic adenoma arising from Krause's gland from the upper fornix because it has no connection with the lacrimal gland.
Of all pleomorphic tumours only 0.5 to 1% occur in the lacrimal gland. Incidence of pleomorphic adenoma of Krause's gland is very rare. The intention of recording this case is that the pleomorphic adenoma of Krause's gland is very rare. Since this tumour has no connection with the lacrimal gland, and is situated in the upper fornix it is likely to be a tumour arising from the Krause's gland. Although it was of 3 years duration, no malignant changes were seen. No other complications were noticed. A case report of pleomorphic adenoma of Krause's gland was described which was excised surgically and proved by histo-pathological examination.
Sincere thanks Dr. N. Bindumadhavarao, Professor of Ophthalmology for his kind guidance in preparing this case report. I also thank the Superintendent, Government General Hospital, Kakinada, for allowing me to publish this case report. I am grateful to Dr. D. Sundarasiva Rao, Professor of Pathology, for supplying the microphotographs.
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