Recurrent Adnexal Gland Carcinoma of the Orbit

Heather Fenley, Chelsea Obourn and Nicholas Purdy

Department of Otolaryngology Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA

^*Correspondance to: Heather Fenley 

 PDF  Full Text DOI: 10.25107/2474-1647.1773

Abstract

Primary orbital adenocarcinoma is a rare disease with few reported cases. Symptom onset is typically late, often resulting in diagnosis at advanced stages. It often originates from the lacrimal gland, but may also arise from Adnexal structures. We report the case of a 62 year old man with recurrent Adnexal gland carcinoma of the orbit who presented 4 years following initial treatment with external beam radiation. MRI at presentation showed a right per orbital mass with extension into the orbit. Head and Neck Tumor Board recommendations were for surgical resection including orbital exenteration with free flap reconstruction. Preoperative PET/CT imaging showed low level uptake at the primary site without evidence of metastases. Intraoperatively, widespread subcutaneous extension of the tumor and metastatic cervical adenopathy unexpectedly necessitated a more aggressive surgical procedure than originally planned. Final pathology showed a high-grade orbital Adnexal adenocarcinoma, with per neural and lymph vascular invasion, and metastases to 8 of 41 cervical lymph nodes. Postoperatively, the patient underwent adjuvant chemotherapy and external beam radiation and has done well. This case highlights the importance of maintaining a high index of suspicion and awareness of disease progression when treating primary orbital adenocarcinoma.

Keywords

Cite the article

Fenley H, Obourn C, Purdy N. Recurrent Adnexal Gland Carcinoma of the Orbit. Clin Surg. 2017; 2: 1773.