Metastatic versus metachronous adenoid cystic carcinoma in the lacrimal gland fossa: a case report

A 53-year-old woman presented with a left painless enlarging lacrimal fossa lesion with hypoglobus and choroidal folds. 18 months earlier, she had undergone surgery and chemoradiotherapy for right maxillary sinus adenoid cystic carcinoma. After initial 1.5T magnetic resonance imaging, a double primary of left lacrimal gland adenoid cystic carcinoma with tricompartmental (frontal bone, lacrimal and temporalis fossa) involvement was suspected. However, subsequent high-field multi-parametric 3T magnetic resonance imaging suggested a solitary metastasis with a subperiosteal location and an uninvolved lacrimal gland. The solitary metastasis was confirmed intraoperatively and pathologically.