Year : 1977 | Volume
: 25 | Issue : 3 | Page : 42--44
Mixed tumour of lacrimal gland
RG Kulkarni1, DL Maria1, AW Bhawathankar2,
1 Dept. of Ophthalmology, Medical College, Aurangabad, India
2 Dept. of Pathology and microbiology, Medical College, Aurangabad, India
R G Kulkarni
Reader in Ophthalmology, S.R.T.R. Medical College, Aurangabad
|How to cite this article:|
Kulkarni R G, Maria D L, Bhawathankar A W. Mixed tumour of lacrimal gland.Indian J Ophthalmol 1977;25:42-44
|How to cite this URL:|
Kulkarni R G, Maria D L, Bhawathankar A W. Mixed tumour of lacrimal gland. Indian J Ophthalmol [serial online] 1977 [cited 2020 Aug 8 ];25:42-44
Available from: http://www.ijo.in/text.asp?1977/25/3/42/31270
Lacrimal gland tumours resemble very much the tumours of parotid glands. Mixed tumour of lacrimal gland may be benign or malignant. This consists of epithelial and mesenchymal elements. There is sufficient controversy regarding the nature of the tumour according to Organizer theory of Memplemann and Womack the tumour matrix consists of epithelial cells while mesenchymal elements are due to Organizer effect of epithelium on the undifferentiated mesoderm.
Mixed tumours are insidious in onset, slow growing and usually appears in fifth decade. The present case being reported due to unusual presentation as axial proptosis in a female.
A 45 years old female patient presented to the Ophthalmic out patient department on 17-6-1976 with the complaints of forward protrusion of right eye, gradual loss of eye sight since 5 years and pain in the eye since 6 months. The was no history of injury, major illness, or of tuberculosis or syphilis.
General and systemic examinations normal. Examination of the right eye showed uniocular axial proptosis of 25 mm. With restricted movements and no vision. The tension was normal. There was no lid oedema, or chemosis. Cornea was clear, with normal anterior chamber. Pupil was dilated and fixed with no direct or concensual reaction to the light.
A tumour mass was palpable on the lateral side of the eye near the orbital margin. The mass was extending from upper outer angle of the orbit to the lower outer angle. It was firm, lobulated, and not mobile. The posterior extent was not reached. The tumour mass was between the orbital wall and the eye ball. There was no tenderness over the tumour mass or orbit. On forcible closure of the lids whole eye ball used to dislocate out side the orbit.
Fundus examination showed optic atrophy following the papilloedema right side with pigmentation at the macula almost two diopter size, dark black in colour, irregular in shape and was superficial. Provisional diagnosis was made as tumour arising from the lacrimal gland.
Left eye examination was normal.
On Investigation Haemogram was within normal limits. Peripheral smear shows no abnormal cells. K.T. and V.D.R.L. All investigations were normal except sugar was also normal X-Ray of the skull which showed a soft tissue shadow in the orbit on lateral side without involvements of bone.
Lateral orbitotomy was done 3-7-1976. The tumour mass which was encapsulated but adherent to lateral rectus was removed in toto. Patient was discharged on tenth post operative day.
Histopathological study of tumour mass showed moiscoid areas, areas showing psudocortilagious appearance and acini and there were areas of degeneration. The over all picture was that of mixed tumour.
Mixed tamour of lacrimal gland are slow growing the patients usualty belong to 5th or 6th decade but Sander 7 has reported two cases at a younger age group of 13 and 17 years respectively. Most of these patients uptil now reported were male. Present case was a female of 45 years old with an axial proptosis. The proptosis was so much that forcible closure of the lids used to push the whole eye ball out of the orbit.
Sander et a1 reported 116 cases of the epethelial tumours of the lacrimal glands. Out of which 59% were benign and 33% were malignant. Hugh Mac Millan Moss reported in his series of cases that these tumours whenever lead to involvement of orbital bones the thickening of these bones could well be palpated. Das has reported 9 cases of mixed tumour in which there was recurrence in 2 cases.
A 45 years old female patient with mixed tumour of right lacrimal gland with axial proptosis of 5 years duration, confirmed histopathologically has been reported.
|1||Das, S.P., 1961, Jour of All India Ophth.Soc., 30.|
|2||Hugh Mac Millan Moss, 1962, Amer. J. of Ophthal, 54, 761|
|3||Jones J.S. and Pfeiffe R.L., 1959, Amer Acad. Ophth., 58,841.|
|4||Maria D.L. et al' 1976. Bombay Hosp.Jour, 18.3 37|
|5||Memplemann, L.H. Jr. and Womack W.A., 1963, quoted by Reese A.B. Tumours of the eye, II Edttion Haper and row, New York.|
|6||Reese A.B., Tumours of eye, II Edition, Haper and Row, New York.|
|7||Sander T.E., 1939, Arch.of Ophth.,21, 232|
|8||Sander T.E., Ackerman L.V. and Zimmerman L.E., 1962, Amer. Journal or Surg., 104, 657.|