Moragrega-Adame E, Velasco-Barona CF, Suárez-Tatá M, Rodríguez-Reyes A

Language: Spanish
References: 15
Page: 40-44
PDF size: 316.15 Kb.

ABSTRACT

We present a case of a 49-years-old female with an eight months history of superior right eyelid swelling, proptosis, diplopia and decreased vision. No personal or familiar illness was referred. The ophthalmic examination was normal in the left eye. The right eye had a visual acuity of 20/80, IOP = 38 mmHg and exophthalmometry of 23/18. In the anterior orbit a supero-temporal painless hard mass was found, and seemed to correspond to a lachrymal gland tumor. At posterior pole, the macular area showed choroidal folds. The patient was referred to echography service where a B-scan was performed, detecting an extraconal supra and infra-temporal lesion with lachrymal gland involvement, not compressible, with heterogeneous density and bone destruction signs. Standardized A-scan revealed a well circumscribed lesion, very low internal reflectivity alternating with areas of medium reflectivity due to a mass with solid and cystic areas. No vascularity was found.
Blood cell count was normal and Bence-Jones protein was absent in serum and urine. Through lateral approach, the surgical resection of the mass was performed. The histopathological findings consisted of a diffuse infiltrate of plasma cells and the immunohistochemistry confirmed the diagnosis of orbital plasmacytoma with lachrymal gland involvement.
This is the first documented case of orbital plasmocytoma with lachrymal gland involvement in 47 years history of the Ophthalmic Pathology Service of our Hospital. The clinical, echographical and histopathological findings will be discussed.

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