RESUMO
A 66-year-old man reported a slowly growing tumor on the lateral edge of his left upper eyelid. This lesion was hard but movable on palpation. A neoplasm of the lacrimal gland was suspected. CT showed a highly calcified lesion at the left upper eyelid. Resection of the tumor was performed, which was located just behind the orbital septum and in front of the lacrimal gland. Anatomopathologic investigation of the excised specimen with immunohistochemistry revealed a benign meningioma of a meningotheliomatous type, containing multiple bone elements. An ectopic orbital meningioma is rare, and this is the first case of a unique lateral localization of this lesion. Therefore, it should be included in the differential diagnosis of a lacrimal gland tumor.
Assuntos
Coristoma/diagnóstico por imagem , Aparelho Lacrimal/diagnóstico por imagem , Neoplasias Meníngeas , Meningioma , Neoplasias Orbitárias/diagnóstico por imagem , Idoso , Coristoma/patologia , Coristoma/cirurgia , Humanos , Imuno-Histoquímica , Aparelho Lacrimal/patologia , Masculino , Mucina-1/análise , Neoplasias Orbitárias/química , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia , Ossificação Heterotópica/patologia , Tomografia Computadorizada por Raios X , Vimentina/análiseRESUMO
A 24-year-old female was referred with epiphora and a non-tender swelling within the right lacrimal fossa, present for 6 months. There were no previous episodes of dacryocystitis. Computed tomography showed a homogenous mass within the lacrimal fossa without contrast enhancement. Pathology following resection of the whole lacimal sac revealed the presence of an inverted papilloma (IP) with a sharp transition between the papilloma and the normal lacrimal duct epithelium. In situ hybridisation was positive for low risk HPV subtypes. An IP is a benign but infiltrative epithelial neoplasm with malignant potential characterised by a high recurrence rate. Majority of cases arise from the nasal wall and paranasal sinuses. In this case report, we demonstrate an IP confined to the lacrimal sac with clear-cut pathology proof, which implicates the lacrimal sac as a primary site of origin.