Dacryoadenoma

From EyeWiki


Dacryoadenoma is a rare conjunctival tumor that is found in children or young adults. It is not known if it is congenital or acquired, as there have been very few case reports ever described. One case was noted in a 33-year-old patient who had the inferior fornix lesion removed when she was 48. It was unknown if she had the lesion since birth. In another case, the lesion was on the bulbar conjunctiva of a 14-year-old girl. It was noted to be a darker red mass on the bulbar conjunctiva, which slowly enlarged over time. This benign tumor originates from the surface epithelium and proliferates into the stroma where it forms glandular lobules similar to the lacrimal gland.

Synonyms

Conjunctival epithelial tumor

Clinical Findings

An exceedingly rare conjunctival tumor that presents as a pink mass in the inferior bulbar or palpebral region.

Etiology

This is a benign tumor that appears to originate from metaplasia of the surface epithelium and proliferates into the stroma.

Diagnostics

Rarely suspected on clinical exam. Histopathology: Metaplasia of the conjunctiva epithelium with invagination into the underling stroma, forming tubules and glands. Electron microscopy: Presence of zymogen type lacrimal secretory granules.

Differential Diagnosis

Differential diagnosis includes lymphoma and other pink- or salmon-colored masses in the conjunctiva.

Prophylaxis

None.

Treatment

Because of the benign nature of this disease, it can be followed with careful monitoring and photography.  However, because of the rarity of this condition and the concern for other more serious problems, an excisional biopsy can help to differentiate this from other possible diseases.

Prognosis

Excellent.

Epidemiology

Children and young adults.

References

  1. Jakobiec FA, Perry HD, Harrison W, et al. Dacryoadenoma. A unique tumor of the conjunctival epithelium. Ophthalmology 1989; 96:1014-1020
  2. Shields JA, Shields CL. Eyelid, Conjunctival, and Orbital Tumors: An Atlas and Textbook. Lippincott Williams & Wilkins, 2008; 2:18:280.
  3. Smolin G, Foster CS, Azar DT, Dohlman CH. Smolin and Thoft’s The Cornea: Scientific Foundations and Clinical Practice. Lippincott Williams & Wilkins, 2005; 40:745.
  4. Yanoff M, Sassani, J Ocular Pathology 6th edition Mosby, 2008; 7: 244.