A 69-year-old male patient was presented to our service with a firm mass at palpation, non-painful, mobile, located in the external portion of the right upper eyelid and of 1 year of evolution.
The tumor mass was not attached to the skin, tarsus or periosteum.
Both visual acuity and ocular motility were preserved.
She also had ptosis and mild proptosis.
She had no relevant personal or family history.
1.
Computed tomography (CT) and magnetic resonance imaging studies showed a well circumscribed rounded mass located in the lacrimal fossa that did not produce too much displacement of the eyeball or bone erosion.
Clinically, instead of a mixed tumour, a dermoid cyst or a ductal cyst (dacryocele) of the lacrimal gland could have been suspected. These lesions are most commonly confused with plemorphous adenoma.
However, orbital dermoid cysts occur at younger ages and have the particularity that CT shows a discrete osteolytic defect with sclerotic margins in the orbital rim.
On the other hand, ductal cysts are observed subconjunctivally with a blue or greyish tonality, are more blandom to a periodic appearance due to their thin capsule size.
Located in clinical and radiographic studies, we do not perform biopsy of the lesion.
Under general anesthesia and using a transseptal approach (anterior orbitotomy), the tumor was removed with care not to damage its capsule.
A 4 cm incision was made in a fold of the upper eyelid and through blunt and sharp divulsion access to the orbicularis muscle was obtained.
The tumor mass was removed together with normal glandular tissue.
1.
The sample was sent for anatomopathological study and the cord was characteristic of the mixed tumor: epithelial tubules and cords immersed in myxomatous and chondroid tissue.
The tumor was well circumscribed and there was no evidence of cellular atypia or malignancy.
The postoperative period was very satisfactory and after one year of follow-up there were no recurrences.
