Metastatic versus metachronous adenoid cystic carcinoma in the lacrimal gland fossa: a case report


  • Posey Po-yin Wong Prince of Wales Hospital, D.O.V.S.,
  • Karen Chan
  • Winnie Chu
  • Kelvin Chong


Carcinoma, adenoid cystic, Lacrimal apparatus, Multiparametric magnetic resonance imaging


A 53-year-old woman presented with a left painless enlarging lacrimal fossa lesion with hypoglobus and choroidal folds. 18 months earlier, she had undergone surgery and chemoradiotherapy for right maxillary sinus adenoid cystic carcinoma. After initial 1.5T magnetic resonance imaging, a double primary of left lacrimal gland adenoid cystic carcinoma with tricompartmental (frontal bone, lacrimal and temporalis fossa) involvement was suspected. However, subsequent high-field multi-parametric 3T magnetic resonance imaging suggested a solitary metastasis with a subperiosteal location and an uninvolved lacrimal gland. The solitary metastasis was confirmed intraoperatively and pathologically.


Shields JA, Shields CL, Epstein JA, Scartozzi R, Eagle RC Jr. Review: primary epithelial malignancies of the lacrimal gland: the 2003 Ramon L. Font lecture. Ophthalmic Plast Reconstr Surg 2004;20:10-21.

Tse DT, Kossler AL, Feuer WJ, Benedetto PW. Long-term outcomes of neoadjuvant intra-arterial cytoreductive chemotherapy for lacrimal gland adenoid cystic carcinoma. Ophthalmology 2013;120:1313-23.

Woo KI, Kim YD, Sa HS, Esmaeli B. Current treatment of lacrimal gland carcinoma. Curr Opin Ophthalmol 2016;27:449-56.

Purohit BS, Vargas MI, Ailianou A, et al. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. Insights Imaging 2016;7:43-68.

Russo C, Strianese D, Perrotta M, et al. Multi-parametric magnetic resonance imaging characterization of orbital lesions: a triple blind study. Semin Ophthalmol 2020;35:95-102.

Chang HY, Jiang H, Zhou F. A rare case of metachronous triple cancers involving the tympanic membrane. Pak J Med Sci 2013;29:218-9.

Blanco M, Garcia-Fontan E, Rios J, Rivo JE, Fernandez-Martin R, Canizares MA. Pulmonar collision tumor: metastatic adenoid cystic carcinoma and lung adenocarcinoma. Rev Port Pneumol 2012;18:42-5.

Lin WY, Hsu WH. Tumor-to-tumor metastasis: maxillary sinus adenoid cystic carcinoma metastasizing to double primary lung adenocarcinoma. Ann Thorac Surg 2010;90:e59-61.

Satake N, Yoshida S, Jinnouchi O, Sekita T. Adenoid cystic carcinoma of maxillary sinus with metastatic hepatocellular carcinoma. Case report. APMIS 2005;113:450-5.

Park DY, Lee JH, Suh YL, Woo KI, Kim YD. Metastatic adenoid cystic carcinoma of the eyelid. Ophthalmic Plast Reconstr Surg 2012;28:e111-2.

Jedrych J, Galan A. Multiple cutaneous metastases: a rare and late sequelae of lacrimal gland adenoid cystic carcinoma. J Cutan Pathol 2013;40:341-5.

Petrelli RL, Labay GR, Schwarz GS. Adenoid cystic carcinoma with orbital and cranial metastases: case report. Ann Ophthalmol 1978;10:611-5.

Kaur A, Harrigan MR, MeKeever PE, Ross DA. Adenoid cystic carcinoma metastatic to the dura: report of two cases. J Neurooncol 1999;44:267-73.

Bacalja J, Magazin M, Ulamec M, Rako D, Trnski D, Kruslin B. Adenoid cystic carcinoma of the lacrimal gland metastatic to the kidney: case report and review of the literature. Scott Med J 2014;59:e14-7.

Maamari RN, Custer PL, Harocopos GJ. Incidentally discovered adenoid cystic carcinoma of the lacrimal gland with isolated liver metastases. Ocul Oncol Pathol 2017;3:262-6.

Zeidan BA, Abu Hilal M, Al-Gholmy M, El-Mahallawi H, Pearce NW, Primrose JN. Adenoid cystic carcinoma of the lacrimal gland metastasising to the liver: report of a case. World J Surg Oncol 2006;4:66.




How to Cite

Wong PY, Chan K, Chu W, Chong K. Metastatic versus metachronous adenoid cystic carcinoma in the lacrimal gland fossa: a case report. Hong Kong J Ophthalmol [Internet]. 2021Aug.17 [cited 2021Sep.24];25(1). Available from:



Case Report