Recurrent Orbital Cylindroma in a Teenager

Adenoid cystic carcinoma (ACC), is one of the most common primary malignant tumors of the lacrimal gland. It accounts for less than 4% of all lacrimal gland tumours. Mean age of incidence is 40 years 1 . It has a poor prognosis, in view of its locally invasive and metastatic potential .2-7 . Radical Excision with negative margin is the treatment of choice. However, the complex anatomy of orbital narrows the extent of radical resection in many cases. We report a case of a 16 year old boy in whom ACC of the lacrimal gland recurred locally in a multifocal pattern following a 3 year disease free interval, after initial excision and adjuvant radiation therapy. The case is unique due to its rarity in the age group as well as successful application of conservative approach in the extent of salvage surgery.