|Year : 1985 | Volume
| Issue : 3 | Page : 181-182
Pleomorphic adenoma of krause's gland in lower lid
JS Saini, AK Mukherjee, Pradeep Naik
Department of Ophthalmology, Goa Medical College, Panaji, India
J S Saini
Department of Ophthalmology, P.G.I. Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Saini J S, Mukherjee A K, Naik P. Pleomorphic adenoma of krause's gland in lower lid. Indian J Ophthalmol 1985;33:181-2
Pleomorphic adenoma in the eye commonly occurs in the lacrimal gland,, but rarely it has been reported to occur in upper lid,, brow, lacrimal sac(5), and orbit. Histologically these tumours shows a mixed origin.
A rare case of pleomorphic adenoma of krause's gland in the lower lid is reported in this communication.
| Case report|| |
RR, 55 years female patient was referred to us with the complaints of a painless, nodular swelling of the outer one third of right lower lid. The patient had noted the swelling 6 years ago and this has been gradually increasing in size since then.
General examination showed no abnormality. Local examination showed a nodular firm swelling involving the outer one third of the right lower lid. [Figure - 1] The swelling measured 3 x 2 x 2 cm and involved the lid margin. It was adherent to the skin but free from the tarsus. Conjunctiva was a thickened and congested but showed no nodular lesion. Fornices were free from any mass. Fundus was normal. Ocular movements were full.
| Clinical examination|| |
There was no proptosis or regional lymphadenopathy. Left eye was clinically normal. The tumour was excised completely under local anaesthesia. No recurrence has been noted for one year now [Figure - 1]B.
| Histology|| |
The specimen on gross examination was a loculated mass, firm in consistency with a capsule surrounding it. Microscopically on Hemotoxylin-Eosin staining the tumour tissue was seen to be highly cellular at some places and in other areas there was abundance of pale staining mucoid and chondroid stroma [Figure - 1]C. Double layered ducts were seen which contained seromucinous material and at few places keratin pearls [Figure - 1]D.
In places epithelial cells were seen arranged in sheets.
| Discussion|| |
Tumours of krause's gland are very rare. These glands which are situated in the conjunctiva near the fornices. number about 20 glands in the upper lid and about 8 glands in the lower lid. Histologically these glands are similar to lacrimal gland. Pleomorphic adenoma affecting the lacrimal gland is not uncommon and has rarely been reported to originate in ectopic islands of lacrimal gland tissue in the limbs, lip, palate, eye lids lacrimal sac and orbit. Glands of krause in the lid has been rarely reported to harbour pleomorphic adenoma. Fuchs' described a large oval tumour in the upper lid which on histology was seen to be pleomorphic adenoma. Descriptions of pleomorphic adenoma in lids have been rare since then.
Clinically our case had a lobulated subcutaneous slowly growing, asymptomatic moveable swelling of the power lid. On histology both epithelial and mesenchymal elements typical of pleomorphic adenoma were seen with a capsule around it. The tumour tissue in our case was subcutaneous.
Of the few reports on pleomorphic adenoma of krause's gland most mention its occurence in the upper lid. Pleornorphic adenoma of krause's gland in the lower lid has been reported only once before probably because of the lesser numerical number of these glands in the lower lid. There has been no recurrence of tumour in our case in one year though such recurrences are reported in literature.
| Summary|| |
Only 0.5 to 1% of pleomorphic adenomas occur in the lacrimal gland. Pleomorphic adenoma of krause's gland is a clinical curiosity as very few case reports exists.
It is a report of a rare case of pleomorphic adenoma originating in the accessory gland of Krause.
| References|| |
Duke-Elder, S, 1965, System of Ophthalmology Vol VIII, Part 11, Henry Kimpton, London.
Rees A B Algernon B , 2nd Edition, Tumours of eys, P. 486, Hobez Medical Div. London.
Pherson, M.C. Samuel, D JR., 1966, Amer J. Ophthalmol 61: 561.
Venkatramayya, Y.K., 1976, Ind. J Ophthalmol 23, IV, 38.
[Figure - 1]