A patient with a past ocular history of presumed thyroid eye disease presented with left eye discomfort and left upper eyelid swelling for two days. She endorsed double vision but denied any blurry vision. Her exam was notable for visual acuity of 20/20 in the right eye and 20/25 in the left eye. IOP was 18 and 21. No APD was noted on exam. Slit lamp examination was notable for severe upper lid swelling, proptosis, and conjunctival injection and chemosis of the left eye. No optic disc abnormalities were appreciated on posterior examination. An MRI of the orbits was obtained revealing a superolateral, well-circumscribed, oval mass of the left globe consistent with a lacrimal gland lesion. A CT scan of the head and face did not reveal any osseous destruction or invasion into neighboring structures by the lesion. A biopsy was taken of the lesion revealing tissue with histologic heterogeneity with both epithelial and mesenchymal elements. A diagnosis of pleomorphic adenoma was made and the patient was planned for complete excision of the tumor. The patient tolerated the procedure without complications and with significant improvement in her symptoms.
Presentation Date: 09/30/2021
Issue Date: 10/08/2021