A Case of Ectopic Lacrimal Adenoid Cystic Carcinoma Developing in the Nasal Orbit

ABSTRACT

PURPOSE: We report a case of ectopic adenoid cystic carcinoma developed on the nasal orbital side adjacent to the nasal cavity. METHODS: A 60-year-old man developed progressive right ocular proptosis and pain for 3 years. The patient had undergone regular medical examination in a hospital but eventually visited our hospital due to aggravated symptoms. Orbit MRI and CT showed a 24 x 36 x 17 mm-sized lower signal mass on the medial side of the right medial rectus muscle and also showed erosion of the orbital bone in the superior and medial orbital walls. An endoscopic biopsy was done after transferring him to the ENT department. A frozen section of the tissue in the operating room showed no malignant evidence, and the mass was excised by endoscopic surgery. The permanent pathological result was adenoid cystic carcinoma. The authors recommended orbital exenteration, but the patient refused the procedure and was seen in follow-up visits after receiving chemotherapy and radiologic therapy. Some orbital mass remained in the posterior orbital area immediately directly after endoscopic excision. The patient underwent his first session of Cyberknife radiosurgery therapy after concurrent chemotherapy and radiologic therapy. CONCLUSIONS: Ectopic adenoid cystic carcinoma should be considered as a differential diagnosis of nasal orbital mass lesions.