A historical form of adenoid cystic carcinoma orbital: about a case

AbstractIntroductionAdenoid Cystic Carcinoma is a slow growing, locally invasive tumor of epithelial origin, mainly from the lacrimal gland. It is a rare tumor and the mortality rate has been found to be quite high (> 50%). Its usual development is done on salivary glands. Its orbital location on lacrimal glands is exceptional. We report the 55‐year‐old patient with advanced orbital cystic adenoid carcinoma.Case ReportA 55 years old female presented to our clinic with complaints of insidious onset, gradually worsening frontal region headache of 6 years duration, proptosis associated with decreased visual acuity, the evolution was marked 3 years ago by the appearance extended orbital mass to the frontal and maxillary region. The evolution was marked 3 years ago by the appearance of an extended orbital mass towards the frontal and maxillary region. The patient came to consultation at a very advanced stage with visual acuity at no light perception,at the inspection we observe an enormous frontoorbitofacial mass taking half of the left hemiface. The slit lamp examination exhibited exposure keratitis and the fundus: optic atrophy and retinal folds. Tomography computed scan revealed: the presence of an intra‐orbital tissue mass which includes the oculomotor muscles and the lacrimal gland measuring 67 * 16 mm pushing back the optic and infiltrating nerve in front of the left periorbital and left frontal palpebral soft tissues, with the presence of bone lysis of the different walls of the orbit . The assessment of extension found: pulmonary micronodules and vertebral lesions. A biopsy was performed and the histo pathological study revealed an adenoid cystic carcinoma. The patient was referred oncology for possible radio chemotherapy.ConclusionCystic adenoid carcinomas of the lacrimal gland are rare, they are malignant tumors that have a very high recurrence rate, and require early diagnosis and early management.