A 30-year-old man presents with slowly progressive painless proptosis, a firm orbital mass that displaces the globe inferomedially, and CT showing a well-circumscribed homogeneous lesion in the superior orbit with moulding to adjacent structures. MRI shows homogeneous low T1 and high T2 signal. What is the most likely diagnosis?
- A Orbital cavernous hemangioma (venous malformation)
- B Lacrimal gland pleomorphic adenoma ✓
- C Orbital lymphoma
- D Sphenoid wing meningioma
Correct answer: B. Lacrimal gland pleomorphic adenoma
Explanation
Pleomorphic adenoma (benign mixed tumour) of the lacrimal gland typically presents in the 3rd-4th decade with slowly progressive painless proptosis and inferomedial globe displacement. CT shows a well-encapsulated superior orbital mass that moulds to bone without erosion. Cavernous hemangiomas are the most common orbital tumours in adults but occur posteromedially and show progressive enhancement on contrast CT. Lymphomas have a more 'salmon-patch' appearance on CT. Complete intact capsule excision is critical to prevent recurrence.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.