The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
a
a
Pseudotumour
involving the lacrimal gland
Photo by Dr. Asok and
Professor Chua
A 24 year-old chef presented with 6-week
history of a rapidly expanding lesion involving the right upper eyelid.
Examination showed the lesion to be warm to touch and on eyelid opening, the
globe was displaced down and in. An urgent CT scan showed a mass in the
lacrimal gland extending into the lateral extraconal space. His blood tests
including auto-immune screening were normal apart from a slightly raised
white cell count. The chest X-ray was normal without signs of sarcoidosis or
tuberculosis. A lacrimal gland biopsy was performed through the skin crease.
The lacrimal gland showed whitish infiltration which was gritty to cut.
However, the histology revealed only inflammatory cells without evidence of
malignancy. The patient was started on high dose steroid starting at 80mg
which was tapered over the next three weeks. The swelling responded rapidly
and he was able to open his eye at two weeks.
Tense upper eyelid swelling.
Side view of the swelling.
CT scan showed lacrimal gland
infiltration with involvement of the lateral extraconal space.
Whitish infiltration of the
lacrimal gland.
Decreased right upper eyelid
swelling with high dose oral prednisolone.
