Massive retinal gliosis (MRG) is a rare, benign intraocular condition resulting from reactive glial cells undergoing exaggerated repair phenomenon. A 52-year-old male presented with 6-year history of enlarging mass in the right eye, associated with progressive vision loss and worsening proptosis. He reported history of trauma to that eye secondary to a vehicular crash one year prior. Magnetic resonance imaging (MRI) of the orbits revealed an intraocular lesion with calcifications raising the possibility of a malignant tumor. Enucleation of the right globe was performed and histopathologic examination revealed the entire vitreous cavity and retina replaced by glial cells arranged in interlacing bundles and whorls with foci of calcifications, highly suspicious of MRG. This was further confirmed by a positive, diffuse, and robust cytoplasmic expression of glial fibrillary protein (GFAP). The disease is known to have favorable outcomes as no complications, such as reemergence of the mass, active bleeding, and secondary infection, were observed from the patient during subsequent visits. Distinction of MRG from other intraocular neoplasms is clinically challenging, hence biopsy is necessary. MRG should be considered as a differential diagnosis when encountering intraocular tumors, especially if there is a history of eye trauma. This is the first reported case of MRG in the Philippines.
Human ; Female ; Middle Aged: 45-64 yrs old ; retinal tumor ; retinal neoplasms

Objective: To describe the clinicopathologic features and outcome of a patient with epithelial-myoepithelial carcinoma of the lacrimal gland who underwent modified lateral orbitotomy with en toto removal of the lesion and adjuvant radiotherapy. Methods: This is a case report. Results: A 31-year-old Filipino male seafarer presented with a 2-month history of an enlarging left superotemporal orbital mass and inferonasal displacement of the globe. Magnetic resonance imaging revealed a superotemporal extraconal mass within the lacrimal sac fossa with evidence of osseous infiltration of the superolateral orbital rim. Modified lateral orbitotomy was performed with en toto removal of the lesion and the clinically infiltrated adjacent lateral bony margin. Histopathologic diagnosis of epithelial-myoepithelial carcinoma of the lacrimal gland was made based on the classic and distinct biphasic morphology and was confirmed with immunohistochemistry studies (cytokeratin-7, S-100, and p63). Systemic surveillance using positron emission tomography and computed tomography scan with contrast revealed no evidence of regional or distant metastasis. Adjuvant radiotherapy of the orbital area was performed for increased local control. Twelve months postoperatively, the patient showed no evidence of tumor recurrence. Conclusion Epithelial-myoepithelial carcinoma of the lacrimal gland is a rare condition, and this is the first documented case from the Philippines. Accurate diagnosis is necessary for appropriate treatment. It should be included in the differential diagnosis of infiltrative lesions in the lacrimal gland fossa.
Lacrimal Apparatus