A 68-year-old man with a recurrent orbital lesion

A 68-year-old man was referred to our oculoplastics clinic by his primary ophthalmologist with a three month history of an expanding mass in his left superotemporal orbit. He had been followed yearly with CT scans since a recurrent left lacrimal gland lesion was removed 26 years ago. The initial lesion was resected 13 years prior to that, when the patient was 29 years old. The pathology reports from both surgeries described a pleomorphic adenoma of the lacrimal gland with no malignant criteria. Neither report indicated whether the tumor had been completely resected. The last CT scan was performed almost a year before symptoms started and was read as stable with no tumor recurrence. His only current complaint was of slight episodic pain in the affected area. He denied any diplopia, vision loss, headache or other systemic symptoms. He was also treated for hypertension, hypothyroidism and dyslipidemia.