The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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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.

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