Oncocytic Carcinoma Ex-Pleomorphic Adenoma of the Lacrimal Gland

Oncocytic carcinoma is a rare malignant neoplasm of oncocytic cells, such cells being characterized by abundant granular eosinophilic cytoplasm, invasive growth, and pronounced cellular pleomorphism. It may arise de novo, or through malignant transformation of a pre-existing benign oncocytoma. Oncocytic carcinoma most commonly occurs in the salivary glands, with rare involvement of the ocular adnexa where it mainly affects caruncle, conjunctiva, and lacrimal sac, and only very arises in the lacrimal gland. This report presents a unique case of a 77-year-old male with lacrimal gland oncocytic carcinoma that probably arose from a pre-existing pleomorphic adenoma; local tumor control was achieved with local excision and adjuvant radiotherapy, but he developed metastasis and died 3 years later. Together with a literature review, this case underlines the aggressive biological behavior of lacrimal gland oncocytic carcinoma, with its high propensity for local and distant recurrence.