A Rare Mucoepidermoid Carcinoma of the Lacrimal Gland

Authors

  • Wendy Zhen, OD, FAAO, DiplABO BronxCare Health System, affiliated with SUNY College of Optometry
  • Alanna Khattar, OD, FAAO, DiplABO BronxCare Health System

Abstract

Purpose

This case report demonstrates the importance of ruling out orbital masses as an etiology in cases of non-resolving proptosis, upper eyelid edema, and diplopia. This report also reviews the key testing required to properly identify or rule out orbital masses.

 

Case Report

A 40-year-old African American male presented for persistent right upper eyelid edema, proptosis, and diplopia in up-gaze following a physical assault more than one year ago. Extraocular muscle testing revealed moderate restriction in up-gaze and mild restriction in abduction of the right eye. Anterior segment examination was remarkable for moderate right upper eyelid chemosis and proptosis. Magnetic resonance imaging (MRI) of the orbits revealed a mass originating from the right lacrimal gland with marked proptosis of the right globe. Biopsy results of the right lacrimal gland mass diagnosed the patient with a rare intermediate to high grade mucoepidermoid carcinoma of the right lacrimal gland. Management included surgical removal of the lacrimal gland tumor, treatment of keratoconjunctivitis sicca following excision of lacrimal gland tissue, and long-term co-management between oculoplastics and oncology.

Conclusion

Proptosis, upper eyelid edema, and/or diplopia can be expected after a recent ocular trauma, but there can also be more serious etiologies with similar presentations. This case report highlights the importance of further investigation and neuro-imaging when a patient presents with these types of non-resolving clinical signs.

Author Biographies

Wendy Zhen, OD, FAAO, DiplABO, BronxCare Health System, affiliated with SUNY College of Optometry

Wendy Zhen, OD was born and raised in Los Angeles, California. She attended the University of California, San Diego for her undergraduate studies where she earned her Bachelor of Science in Human Biology. She continued her education at Illinois College of Optometry where she received her Doctorate of Optometry in June 2019. She then completed a Primary Eye Care/Ocular Disease Residency at BronxCare Health System, affiliated with SUNY College of Optometry in June 2020.

Alanna Khattar, OD, FAAO, DiplABO, BronxCare Health System

Dr. Alanna Khattar graduated from the Southern College of Optometry and completed a Primary Eye Care/Ocular Disease Residency at Bronx-Lebanon Hospital Center. Dr. Khattar is currently the co-supervisor of the Primary Eye Care/Ocular Disease Residency Program at BronxCare Health System.

Published

2023-03-02

How to Cite

Zhen, W., & Khattar, A. (2023). A Rare Mucoepidermoid Carcinoma of the Lacrimal Gland. Canadian Journal of Optometry, 85(1), 49–54. Retrieved from https://openjournals.uwaterloo.ca/index.php/cjo/article/view/3469

Issue

Section

Original Research