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Pleomorphic adenoma of the palpebral lacrimal gland

Photo by Dr. Yew Yen Han and Dr. Adrian Koay

 

A 65 year-old woman presented with a three-year history of progressive swelling of the left upper eyelid. CT scan showed a mass in the upper eyelid that did not invade the orbit. Excisional biopsy was performed through a skin crease incision and the mass was excised en bloc. Histology showed this to be a pleomorphic adnoma of the lacrimal gland.

 

Left upper eyelid swelling with ptosis.   The mass viewing from the mass showing fullness of the left upper eyelid.   CT scan shows eyelid mass anterior to the globe.   Coronal CT scan shows no orbital invasion by the eyelid mass.   Skin crease incision to excise the lesion.   Opening of the orbital septum to reveal a whitish rubbery mass.   The full extent of the anterior surface of the mass after dissecting the surrounding tissue.   A 4/0 silk was passed through the mass to aid dissection of the lesion.     The lesion was excised together with levator aponeurosis which was attached to it.   The upper end of the levator aponeurosis was identified.   The upper end of the levator aponeurosis was sutured to the tarsal plate to prevent post-operative ptosis.     The excised lesion.   Appearance of the eye 24 hours post-operative.   Appearance of the eyelid at 2 weeks post-operative.

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