Lacrimal Gland Choristoma of the Ciliary Body Presenting as Secondary Glaucoma.
Elizabeth Verner-Cole, Mukul Divatia, Dan Gombos, Patricia Chevez-Barrios. The Methodist Hospital, Houston, TX; MD Anderson Cancer Center, Houston, TX
Background: Lacrimal gland choristoma is a rare entity that can be difficult to diagnose clinically, usually requiring enucleation for definitive diagnosis. Described here is a case of lacrimal gland choristoma of the ciliary body presenting as secondary glaucoma in a young child.
Design: Case report.
Results: A one year-old boy presented at 6 months of age with unilateral glaucoma of the left eye.
After showing no response to medical treatment, a glaucoma filtering device was surgically implanted into the left eye. He then developed a cataract that required lensectomy. A ciliary body mass was noted during the cataract surgery. It was decided to enucleate the eye with the problable diagnosis of medulloepithelioma. The cut surface of the eye showed the implanted reservoir on the superior surface, irregular synechia of the iris to the cornea, and a yellowish mass in the inferior area of the ciliary body associated to opaque whitish bands of vitreous. Histologic sections showed a ciliary body mass composed of benign-appearing lacrimal (serous) glandular tissue with iris tissue lined by cuboidal ductal-type epithelium. Immunohistochemistry analysis (pankeratin, p63, S100, CEA) revealed staining patterns of normal lacrimal gland, consistent with a lacrimal gland choristoma of the ciliary body. PAS and CEA stains were positive in the droplets of glandular secretions in the vitreous.
Conclusions: Although a rare lesion, lacrimal gland choristomas should be in the differential diagnosis of children with unilateral glaucoma and a ciliary body/iris mass. Histologically the choristoma may contain all the structures of the lacrimal gland including the ductal epithelium, basal myoepithelial cells and serous cells with production of secretions like in this case.
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 285, Wednesday Afternoon