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A rare case of epithelial‐myoepithelial carcinoma arising from pleomorphic adenoma of the lacrimal gland
Author(s) -
Van Rooij Nicholas,
Newman Alexander,
Sullivan Timothy
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.0033
Subject(s) - lacrimal gland , myoepithelial cell , pleomorphic adenoma , medicine , pathology , adenoid cystic carcinoma , salivary gland , carcinoma , biopsy , adenoma , immunohistochemistry
Purpose Epithelial‐myoepithelial carcinoma (EMC) is a low‐grade salivary gland tumour which is very rarely reported in the lacrimal gland. Hybrid carcinomas such as EMC, defined by Seifert and Donath (1996), 1 comprise two histological subtypes of carcinoma within the same topographic field. Hybrid tumours constitute <1% of all salivary gland tumours, with only eight previous documented cases of lacrimal gland EMC reported in the literature. 2 The diagnosis of EMC is histological, demonstrating a biphasic dual morphology of luminal cuboidal ductal epithelial cells and outer myoepithelial cells with clear cytoplasm. 1,2Methods/Results We describe the case of a 92‐year‐old transgender man that presented with progressively worsening left‐sided headaches, eye pain and with a clinical enlargement of the left lacrimal region. The patient underwent superior‐lateral orbitotomy with excisional biopsy of the left lacrimal gland and was found to have EMC arising from a pleomorphic adenoma, which was subsequently managed with adjuvant rotation therapy. Conclusions Patient prognostication and optimal management of these tumours provide a challenge for clinicians due to their inherent rarity. We describe the first case of EMC arising within a pleomorphic adenoma in the Australian population. References 1. Seifert G, Donath K. Hybrid tumours of salivary glands. Definition and classification of five rare cases. European Journal Of Cancer Part B, Oral Oncology 1996; 32B: 251‐259. Li E, Distefano A, Sinard J, Wong A, Pointdujour‐Lim R. Epithelial‐myoepithelial carcinoma presenting as a pseudo veno‐lymphatic malformation. Ophthalmic Plastic And Reconstructive Surgery 2018; 34: e157‐e60.