Área Técnica: Órbita
SOLITARY FIBROUS TUMOUR OF LACRIMAL GLAND MIMICKING A PLEOMORFIC ADENOMA
Report a case of solitary fibrous tumour (STF) of lacrimal gland mimicking a pleomorphic adenoma. SFT is a rare mesenchymal spindle cell neoplasy most commonly found in the pleura, rare in the orbit and extremely rare in lacrimal gland
A 38-year-old woman presented with swelling in the left supero-lateral aspect of the orbit (lacrimal gland region) for past four years. There was history of gradual increase in size of the lesion. She had no history of trauma. No associated ocular complaints were present. External examination revealed a palpable tumour in the orbit, specifically in lacrimal gland topography.Magnetic resonance imaging (MRI) revealed an extraconal solid nodule with precised limits in the left lacrimal gland, with intense heterogeneous enhancement by contrast, measuring about 2 x 2 x 1.4 centimeters. The mass was fully excised by a lateral orbitotomy approach and a macroscopic presumptive diagnosis was a typical pleomorfic adenoma. The excised tumour was ovoid and firm, with measurements of 2 × 2 × 1.5 cm. The histopathological analysis of the tumour revealed a mesenchymal neoplasy with spindle cell proliferative lesion, hemangiopericytoma-like pattern that was encircled by the lacrimal gland parenchyma. Immunohistochemical analysis showed that the spindle cells were highly positive for CD34 and STAT6. S-100 protein and smooth muscle actin (SMA) were not detected. The diagnosis of a SFT was done based on the immunohistochemical and histological findings.
SFT is a rare tumour in lacrimal gland region. The histopathological examination in association with IHC findings are essential for correct diagnosis.