A 40-year-old man presents with a 2-year history of painless, progressive right-sided proptosis and inferior displacement of the globe. CT scan shows a well-circumscribed, homogeneous mass in the superotemporal orbit with a smooth bony impression. The most appropriate management is:

• A Incisional biopsy followed by wide local excision
• B High-dose systemic corticosteroids
• C Intact excision without breaching the pseudocapsule ✓
• D Fine-needle aspiration cytology followed by radiotherapy

Explanation

Pleomorphic adenoma of the lacrimal gland is benign but its pseudocapsule contains tumor cells. Incisional biopsy or rupture during excision causes spillage, leading to seeding and high recurrence rates. Intact excision without breaching the pseudocapsule is mandatory. Corticosteroids are reserved for inflammatory conditions like dacryoadenitis or pseudotumor, which present more acutely with pain and tenderness.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.