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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.
DESCRIPTION OF FINDINGS
CT scans demonstrate a variety of different lacrimal gland lesions with additional MRI for case C.
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Case A demonstrates a homogenous round mass involving the deep or orbital lobe of the left lacrimal gland.
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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.
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Cases C, D, and E demonstrate a variety of entities diffusely involving the lacrimal glands.
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Case C lacks a discrete mass but instead demonstrates diffuse gland involvement affecting both superficial and deep lobes.
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In addition to the morphology, restricted diffusion can aid in narrowing the differential diagnosis in these masses that diffusely involve the lacrimal gland.
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Case D demonstrates bilateral diffuse lacrimal gland involvement and enlargement of the superior recti muscles bilaterally.
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Case E demonstrates only mild bilateral lacrimal gland enlargement, but additional findings in the parotid gland help narrow the differential diagnosis.
Diagnosis
Case A
Benign mixed tumor (BMI)/pleomorphic adenoma
Case B
Adenoid cystic carcinoma (ACC)
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