Pleomorphic adenoma of the lacrimal gland in an 18-year-old girl irradiated for bilateral retinoblastoma

Orbital pathology - Iatrogenic findings and artefacts

The relationship between the ophthalmologist and ophthalmic pathologist is particularly important in orbital disease, as diagnosis is heavily dependent on correlation with clinical context. If the patient has previously had treatment to the orbit or an adjacent area, whether for the same or a different condition, tissue changes may occur which affect the histological appearance of any specimen taken. This article is an overview of therapeutic interventions which may cause either orbital pathology or an altered appearance of the tissue, either of which can pose a diagnostic challenge. The problem of artefact is also addressed as another factor which may alter the appearance of a specimen. It is hoped that the information provided in this brief review will help clinicians better evaluate what information may be relevant when submitting a specimen.

Pseudoadenomatous Hyperplasia of the Inferior Forniceal Conjunctiva Due To Prosthetic Irritation in an Anophthalmic Socket

Secondary complications in an anophthalmic socket can include late appearing shrinkage due to scarring and squamous cell carcinoma. This article reports a 51-year-old man who 27 years after an enucleation developed an inability to retain his ocular prosthesis due to an acquired multilobular fleshy mass in his inferior fornix. The patient had worn his prosthesis without removal for years at a time. Microscopic evaluation of the excised lesion disclosed a pseudoadenomatous (pseudoglandular) hyperplasia of the conjunctival epithelium with myriad goblet cells and accompanying chronic inflammation. In cross section, these structures microscopically resembled an adenoma but were found to display multifocal origins from the surface epithelium resembling exaggerated pseudoglands of Henle. Simple excision without recurrence 6 months later has permitted a new prosthesis to be comfortably worn with stability.

Papillary cystadenocarcinoma of the lacrimal gland after radiation for bilateral retinoblastoma

The authors report a case of papillary cystadenocarcinoma of the lacrimal gland after irradiation for bilateral retinoblastoma. A 32-year-old man with a history of bilateral retinoblastoma, diagnosed shortly after birth, was treated with enucleation of the OS and a single session of radiation to the OD. Over 30 years later, he presented with an orbital mass of the right lacrimal gland that on biopsy demonstrated papillary cystadenocarcinoma.

[Adenocarcinoma of the lacrimal gland in bilateral retinoblastoma treated with external radiotherapy: a case report]

This clinical case report describes the clinical findings and diagnosis of lacrimal gland adenocarcinoma that developed 20 years after external beam radiotherapy in the treatment of bilateral retinoblastoma. Visual acuity, slit lamp biomicroscopy, fundus color photography, nuclear magnetic resonance, lateral orbitotomy and histological analysis are described.