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

No abstract available.
Adenocarcinoma ; Lacrimal Apparatus

No abstract available.
Adenocarcinoma ; Lacrimal Apparatus

Cysts of accessory lacrimal gland are rare. They are generally retension cysts that result from obstruction of the excretory duct and are found between the palpebral conjunctiva and the levator aponeurosis. We experienced three cases of subconjunctival cyst in the upper fornix. Histopathological examination showed the cysts lined by two layers and occasionally one layer of epithelium. These cysts seem to be originated from Krause's gland, considering their anatomical location and histopathological findings.
Conjunctiva* ; Epithelium ; Lacrimal Apparatus

The medical literature contains few reports of ectopic lacrimal gland. Ectopic lacrimal gland has been observed in the eye and in various sites in the ocular adnexa. The authors had experienced one case of ectopic lacrimal gland in the super olateral side of orbit. The authors report this case with the review of literatures.
Lacrimal Apparatus* ; Orbit*

No abstract available.
Carcinoma, Mucoepidermoid* ; Lacrimal Apparatus*

This was a case of a young lady presenting with 10 year history of a mass in the right eye. It was found to be an adenocarcinoma of the lacrimal gland from histopathological biopsy. She underwent wide excision, orbital exenteration and reconstruction with a free rectus abdominis flap. Unfortunately, she had a tumour recurrence which was not controlled by radiotherapy and a second excision. The behavior of the tumour was aggressive, resulting in widespread metastases. She passed away within a year of her presentation. Of note, the histopathology report from the second excision turned out to be sarcomatoid carcinoma. This is described in the literature as dedifferentiation, or high grade transformation (HGT). Occurrence of dedifferentiation in salivary gland tumours is well-established, but not as well-described in lacrimal gland tumours. In this case, there was a severely delayed presentation of a lacrimal gland adenocarcinoma in a young person, which underwent dedifferentiation into a sarcomatoid carcinoma. This phenomena is associated with aggressive tumour biology behavior and poor prognosis, despite surgery and radiotherapy.
Adenocarcinoma ; Lacrimal Apparatus

Objective: To describe the cytopuncture microbiopsy (CM) technique performed during transcanalicular endoscopic lacrimal duct recanalization (TELDR) in patients with primary acquired nasolacrimal duct obstruction (PANDO) as an alternative to open biopsy, the standard method used in collecting specimen. Methods: This is a noncomparative, interventional case series with histopathologic correlation. Patients diagnosed with complete PANDO who underwent TELDR with balloon dacryoplasty and silicone intubation with CM at University of Santo Tomas Hospital from October 2014 to January 2017 were included. Results: Twenty (20) tissue specimens from the lacrimal sac and nasolacrimal duct were obtained from 18 patients. There were 16 females and 2 males included in the study. Mean age was 57.5 years. All specimens revealed few clusters of benign epithelial cells with few degenerated mononuclear cells and lymphocytes, and singly scattered lymphocytes that are set in fibrinous background. Tissue cytology studies were negative for malignant cells. Conclusion CM is a minimally invasive procedure that offers an alternative to open biopsy technique that can be done routinely during TELDR.
Dacryocystorhinostomy ; Lacrimal Apparatus Diseases

PURPOSE: The correspondence between the canaliculus irrigation test, dacryocystography, and Jones test in patients with epiphora was investigated. METHODS: The study included 494 eyes of 359 patients who complained of epiphora and underwent both canaliculus irrigation test and dacryocystography from May 2001 to March 2006. Sixty-eight eyes from 34 patients diagnosed with functional lacrimal duct obstruction took Jones tests. Factors such as age, sex, duration of epiphora, and site of obstruction were analyzed in terms of correspondence of the tests. RESULTS: Between the canaliculus irrigation test and dacryocystography, correspondent rate was 55%. Correspondence had no relation to patient age, sex, duration of epiphora, or site of obstruction. Between Jones test and dacryocystography, the correspondent rate was 47%. Factors affecting the correspondences were not significantly found. CONCLUSIONS: A canaliculus irrigation test can give useful information with high correspondence rate of dacryocystography in the case of 'not pass' or 'pass without regurgitation'. Therefore dacryocystography should be utilized in "pass with regurgitation" cases by canaliculus irrigation test.
Humans ; Lacrimal Apparatus Diseases* ; Lacrimal Duct Obstruction

PURPOSE: To evaluate the internal ostium and lacrimal sac change after external dacryocystorhinostomy (DCR) using digital subtraction dacryocystography (DCG). METHODS: Between May 2003 and July 2004, digital subtraction DCG was performed to assess the ostium and lacrimal sac 6 months after external DCR in 48 patients (n=50 eyes). RESULTS: The lacrimal sac had reformed in 45 (90%) eyes. Mean ostium size was 2.4 mm (0.5~6.1 mm) and these were located at the inferior part of the reformed sac in 39 eyes (78%). Patients with a fistula-type internal ostium, of which the lacrimal sac had not reformed, often complained of epiphora (p=0.005). CONCLUSIONS: Digital subtraction DCG showed successful anatomic changes in the distal lacrimal pathway and confirmed that the internal ostium contracts into a relatively small ostium after DCR. A fistula-type internal ostium may explain the pathophysiology of functional failure after successful DCR.
Dacryocystorhinostomy* ; Humans ; Lacrimal Apparatus Diseases