title: Epithelial-myoepithelial carcinoma of lacrimal gland from an ex pleomorphic adenoma.
abstract: A 47-year-old man with a history of recurrent pleomorphic adenoma of the right lacrimal gland presented with rapid onset of a swelling in the right orbit. Initial imaging with CT showed that the swelling was grossly involving the extraocular muscles. Hence we had a suspicion of malignant transformation, so a radical approach in the form of right orbital exenteration with anterior skull base resection and temporalis muscle reconstruction was taken. Postoperative histology revealed epithelial-myoepithelial carcinoma, with immunopositivity for epithelial and myoepithelial components. Adjuvant radiation of 60 Gy was given with three-dimensional CT-based planning. This case portrays the importance of adjuvant treatment in recurrent pleomorphic adenoma and chance of malignant transformation in rare histologies.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhanu Prasad
authors.initials: BP
authors.lastname: Venkatesulu
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Pathy
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Archana George
authors.initials: AG
authors.lastname: Vallonthaiel
authors.affiliation: Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Chawla
mesh_terms: D008949:Adenoma, Pleomorphic / Q000473:pathology*; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000175:diagnosis* / Q000628:therapy; D017233:Orbit Evisceration; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome