Solitary Fibrous Tumour of Lacrimal Gland: A Rare Entity

Abstract

A 52-year-old male presented to the ophthalmology outpatient department with complaints of swelling in the left supero-lateral aspect of the orbit (lacrimal gland region) for past two years. Patient gave history of gradual increase in size of the lesion. On examination, the swelling was apparently soft and non tender. He ruled out any history of trauma at this site. No associated ocular complaints were present. Routine investigations like Complete blood counts, Liver function tests, Renal function tests, Viral markers (HIV, HbsAg and HCV) were unremarkable. Magnetic resonance imaging (MRI) and FNAC were advised with clinical possibility of Lipoma. MRI revealed an extra corporal mass on supero lateral aspect of left orbit possibly lacrimal in origin [Table/ Fig-1]. FNAC smears were scantily cellular and exhibited spindle shaped cells with bland chromatin and inconspicous nucleoli against a haemorrhagic background. Scant cellularity hampered the diagnosis and only a suggestion of neoplastic nature of the lesion was offered. Wide local excision of the lesion was planned and tissue was sent for histopathology.Histopathological examination revealed partly encapsulated cellular tumour arising from the lacrimal gland. The tumour cells were arranged in patternless sheets and fascicles with focal storiform pattern. The tumour cells had spindle shaped nuclei with moderate Pathology SectionSolitary Fibrous Tumour of Lacrimal Gland:A Rare Entity aBstRaCt Solitary fibrous tumour (SFT) is a rare spindle cell tumour of mesenchymal origin most commonly encountered in pleura. It can affect the orbital region but SFT of lacrimal gland is rare. We hereby report of a SFT of lacrimal gland in a 50-year-old male presenting with slow growing swelling in left superolateral orbital region. The preliminary fine needle aspiration cytology (FNAC) could not reveal any definite diagnosis. Excision biopsy and immunohistochemistry (IHC) confirmed the diagnosis. Therefore, clinician and pathologist should be aware of this entity and biopsy along with IHC is required to rule out other entities which can mimic it clinically and histopathologically.Vikram NaraNg 1 , Nagi aNitaraj rajeNdra SiNgh 2 , gurkirat SiNgh Bajwa 3 , NeeNa Sood 4 amount of ill defined eosinophilic cytoplasm and an occasional mitotic figure. Histomorphology was suggestive of benign spindle cell tumour. IHC was done to rule out the possibility of schwannoma/ hemangiopericytoma. On IHC the tumour cells were positive for CD34, Vimentin and negative for SMA and S100 on IHC [Table/ Fig2a-d]. The MIB1 labelling index was less than 1%. Hence, the final diagnosis of SFT of lacrimal gland was made. The patient is now on follow up and shows no evidence of local recurrence. DisCussionSFT is a rare tumour of adults that originally was believed to be derived from mesothelium. However, the subsequent identification of this tumour in sites not usually associated with serosal surfaces, including the thyroid and parotid glands, nasal cavity, and paranasal sinuses, supports a mesenchymal origi...

Solitary Fibrous Tumor in the Lacrimal Gland Fossa: A Case Report

“…SFTs arise in many locations of the orbital soft tissues, but commonly involve the superior area [ 1 ]. Since Scott et al [ 2 ] first reported SFT in the lacrimal gland fossa in 1996, there have only been 9 reported cases in the lacrimal gland fossa (table 1 ) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. We report a case of SFT in the lacrimal gland fossa presenting at a young age, including features of imaging, histological and immunohistochemical studies.…”