A 60-year-old woman with an asymptomatic left lacrimal gland mass found incidentally

Abstract

A 60-year-old woman with a history of recurrent, poorly differentiated adenocarcinoma of the left maxillary sinus was referred to the Orbital Oncology Service of the University of Texas MD Anderson Cancer Center for evaluation and management of a slow growing, asymptomatic left lacrimal gland mass that was incidentally identified on routine surveillance magnetic resonance imaging (MRI). The patient denied significant vision changes, diplopia, and pain associated with the lesion. Other past pertinent oncologic and ophthalmologic history included treatments for the maxillary sinus adenocarcinoma with multiple surgical resections, including a maxillectomy and high-dose radiation of 60 Gy to the nasal cavity and 50 Gy to the right and left neck lymph nodes, and repeated proton beam therapy to the sinonasal region for a local recurrence. The patient’s ocular history was significant for a bilateral dacryocystorhinostomy and left conjunctivodacryocystorhinostomy for nasolacrimal duct blockage and canalicular stenosis secondary to treatments for her sinonasal cancer. Additionally, she was diagnosed with iritis of the right eye 5 months prior to presentation by her local ophthalmologist that had resolved with topical steroids and was felt to be idiopathic in nature.