A 37-year-old woman presenting with blurred vision and a bulging left eye for the past 2 months. Ax , axial; CT , computed tomography.

A 59-year-old man presenting with ptosis of the right eye and an irregular superior orbital rim. Ax, axial; Cor, coronal; CT, computed tomography.

A 76-year-old woman presenting with a lump in her superolateral left orbit. ADC, apparent diffusion coefficient; Ax, axial; CT, computed tomography; DWI, diffusion-weighted imaging.

A 23-year-old presenting with a 2-year history of bilateral eyelid swelling with proptosis. Ax, axial; Cor, coronal; CT, computed tomography.

A 54-year-old woman presenting after a motor vehicle crash. Ax, axial; CT, computed tomography.


CT scans demonstrate a variety of different lacrimal gland lesions with additional MRI for case C.

  • Case A demonstrates a homogenous round mass involving the deep or orbital lobe of the left lacrimal gland.

  • Case B demonstrates a mass that appears to be similar to the one in Case A; however, internal calcifications and adjacent bony changes are present.

  • Cases C, D, and E demonstrate a variety of entities diffusely involving the lacrimal glands.

  • Case C lacks a discrete mass but instead demonstrates diffuse gland involvement affecting both superficial and deep lobes.

  • In addition to the morphology, restricted diffusion can aid in narrowing the differential diagnosis in these masses that diffusely involve the lacrimal gland.

  • Case D demonstrates bilateral diffuse lacrimal gland involvement and enlargement of the superior recti muscles bilaterally.

  • Case E demonstrates only mild bilateral lacrimal gland enlargement, but additional findings in the parotid gland help narrow the differential diagnosis.


Case A

Benign mixed tumor (BMI)/pleomorphic adenoma

Case B

Adenoid cystic carcinoma (ACC)

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