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A 68-year-old man with a recurrent orbital lesion
Digital Journal of Ophthalmology 2009
Volume 15, Number 4
September 2, 2009
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Marc-Andre Rheaume, MD | University of Montreal
Guy Allaire, MD, FRCPC | University of Montreal
Akram Rahal, MD, FRCSC | University of Montreal
Vijayabalan Balasingam, MD, FRCSC, PhD | University of Montreal
Patrick R. Boulos, MD, FRCSC | University of Montreal
Differential Diagnosis
The differential diagnosis of orbital tumors is extensive. Lymphoid tumors and inflammatory disorders (idiopathic orbital inflammation, inflammation related to a systemic disorder) are the two most common causes of lesions in the lacrimal gland area. Epithelial tumors including pleomorphic adenoma (benign mixed tumor), malignant mixed tumor and adenoid cystic carcinoma are also relatively common. Other possibilities include infectious dacryoadenitis, metastases, dermoid cyst and a lacrimal gland cyst (dacryops).

In our patient, the past history of an incompletely resected pleomorphic adenoma combined with the aggressiveness of the recurrence he was experiencing pointed to a diagnosis of carcinoma ex-pleomorphic adeoma (malignant mixed tumor).