Ectopic Lacrimal Gland Tissue: A Systematic Review

Abstract

We review the clinical and histopathological findings associated with ectopic lacrimal gland tissue. Ectopic lacrimal gland tissue is susceptible to neoplastic transformation in the same way as is the lacrimal gland. Supplemental Digital Content is available in the text. Purpose: To review the clinical and histopathological findings associated with ectopic lacrimal gland tissue. Methods: A systematic review of the literature on ectopic lacrimal gland tissue was performed. Studies which met clinical and histolopathological criteria for ectopic lacrimal gland tissue written in English and published in peer-reviewed journals were included. Results: Sixty-nine publications detailing 180 cases of ectopic lacrimal gland tissue were published between 1946 and 2018. Males were affected slightly more than females (57% vs. 43%) and 95% cases were unilateral. Patients presented at a mean age of 21 years, most commonly with a mass, although orbital lesions commonly presented with proptosis. The most common location for ectopic lacrimal gland tissue was epibulbar conjunctiva (62%), other locations included orbital (16%), eyelid (11%), intraocular (9%), lacrimal sac (2%), and nasal mucosa (0.6%) sites. Most lesions (86%) were locally resected. The most common histological types were complex choristomas (56%) and simple choristomas (38%). However, neoplastic transformation to pleomorphic adenoma (5%), adenocystic carcinoma (0.6%), and adenocarcinoma (0.6%) was reported. Conclusions: Ectopic lacrimal gland tissue is rare but should be considered in the differential diagnosis of masses in the epibulbar conjunctiva, eyelid, orbit, and lacrimal sac, particularly in childhood, as the diverse way it presents means that it may mimic more common choristomas. It can undergo neoplastic transformation in the same way as can the lacrimal gland and incomplete excision can result in recurrence.

Ectopic lacrimal gland causing intermittent proptosis

“…Complex and simple choristoma are the most common histopathological subtypes of the ectopic lacrimal gland. [ 14 ] Neoplastic transformation of the ectopic lacrimal gland, for example, to pleomorphic adenoma and adenocarcinoma, is extremely rare but has been reported. [ 5 14 ]…”

“…[ 14 ] Neoplastic transformation of the ectopic lacrimal gland, for example, to pleomorphic adenoma and adenocarcinoma, is extremely rare but has been reported. [ 5 14 ]…”

Dacryops with extensive lacrimal and maxillary bone defects in four dogs

“…Furthermore, no connection to the lacrimal gland of the third eyelid and the caruncle could be determined in the cases included in this study. The most common location of ectopic lacrimal gland tissue in humans is the epibulbar conjunctiva (62%), and other locations include the orbital (16%), eyelid (11%), intraocular (9%), lacrimal sac (2%), and nasal mucosa (0.6%) sites 23 . One case report on humans stated that the development of an orbital ectopic lacrimal gland cyst is extremely rare 24 .…”

Adenoid cystic carcinoma of the palpebral lobe of the lacrimal gland – case report and literature review

“…These nonspecific clinical features include a wide range of differential diagnoses, such as chalazion, dermoid or sebaceous cysts, as well as epithelial and non-epithelial lesions of the lacrimal gland, including dacryops, dacryoadenitis or lymphoma. In addition, ectopic lacrimal gland tissue may present in the upper or lower eyelid as masses, 21 where benign and malignant lesions can develop. In our patient, although the lesion could be similar in shape and topography to a chalazion, careful palpation allowed its location outside the tarsal plate.…”