title: Primary adenoid cystic carcinoma of the conjunctiva arising from the accessory lacrimal glands: a clinicopathologic study of three cases.
abstract: OBJECTIVE
  To report 3 cases of primary adenoid cystic carcinoma originating from the accessory and/or ectopic lacrimal glands of the conjunctiva.
  
  
  METHODS
  We examined 3 conjunctival tumors histopathologically. The specimens were fixed in 10% formalin. Sections were cut at 5 microm, and the slides were stained with hematoxylin-eosin, periodic acid-Schiff, alcian blue, and colloidal iron methods.
  
  
  RESULTS
  We report 3 conjunctival tumors that histopathologically proved to be adenoid cystic carcinomas that had arisen from the accessory lacrimal glands of the conjunctiva (cases 1 and 2) and from ectopic lacrimal gland tissue (case 3). The age of the patients ranged between 53 and 68 years. In 2 of the cases, the tumor involved the tarsal conjunctiva. The third patient had a mass involving the limbal conjunctiva and two thirds of the cornea inferiorly. Histopathologically, acini of accessory lacrimal glands of the conjunctiva were found near the neoplastic lobules in 2 of the tumors. Foci of perineural invasion were observed in 1 of the tumors (case 1). Follow-up examination showed no evidence of recurrence or metastatic disease in cases 1 and 2 (10 and 8 years, respectively). In case 3, the patient was alive and without any evidence of recurrence 1 year after surgical excision of the mass.
  
  
  CONCLUSIONS
  Adenoid cystic carcinoma arising from the accessory lacrimal glands of the conjunctiva is a rare occurrence. Only 2 previously reported cases have appeared in the literature, and to our knowledge, there are no reports of this tumor arising from ectopic lacrimal gland tissue in the conjunctiva. Follow-up studies are mandatory to evaluate the biologic behavior of the tumor.
authors.affiliation: Ophthalmic Pathology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA. rfont@bcm.tmc.edu
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Font
authors.forename: Maria
authors.initials: M
authors.lastname: Del Valle
authors.forename: José
authors.initials: J
authors.lastname: Avedaño
authors.forename: Marc
authors.initials: M
authors.lastname: Longo
authors.forename: Milton
authors.initials: M
authors.lastname: Boniuk
mesh_terms: D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology* / Q000601:surgery; D003230:Conjunctival Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged