{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:56:38Z","timestamp":1781614598429,"version":"3.54.5"},"reference-count":20,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Pleomorphic adenoma of the lacrimal gland is a benign epithelial neoplasm and can rarely undergo cystic degeneration, mimicking other conditions with similar radiological findings. It commonly presents as a slow growing, painless mass in the outer upper eyelid, characterised by exophthalmos, ptosis, diplopia and reduced ocular movements. Here, we present one such case of a male in his mid-30s presenting with a painless, progressive fullness in the left upper eyelid with mild proptosis and restricted ocular movements which was initially suspected to be due to an underlying dermoid cyst owing to the cystic nature of the lesion on imaging. Surgical intervention involving complete excision was preferred, rendering no recurrence on follow-up. Histopathological examination however revealed microscopic features suggestive of a pleomorphic adenoma with cystic changes contrary to the initial diagnosis of a dermoid cyst. This case highlights the challenges faced in arriving at the right diagnosis with successful treatment outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-270913","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:15:15Z","timestamp":1781612115000},"page":"e270913","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cystic degeneration of pleomorphic adenoma of the lacrimal gland: a diagnostic dilemma"],"prefix":"10.1136","volume":"19","author":[{"given":"Fatima Kauser","family":"Zubair","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Osmania Medical College, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y Sai","family":"Karthik","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Osmania Medical College, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Gogineni","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Osmania Medical College, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5023-1147","authenticated-orcid":false,"given":"Sumith Marian","family":"Colaco","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"2026061605150771000_19.6.e270913.1","unstructured":"Machiele R , Lopez MJ , Czyz CN . Anatomy, head and neck: eye lacrimal gland. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2023. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532914\/"},{"key":"2026061605150771000_19.6.e270913.2","first-page":"159","article-title":"An Update on Tumors of the Lacrimal Gland","volume":"6","author":"Andreasen","year":"2017","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"2026061605150771000_19.6.e270913.3","doi-asserted-by":"crossref","first-page":"W371","DOI":"10.2214\/AJR.12.9553","article-title":"Lacrimal gland masses","volume":"201","author":"Gao","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"2026061605150771000_19.6.e270913.4","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/IOP.0b013e31829f3a0c","article-title":"Clinicopathologic Review of Epithelial Tumors of the Lacrimal Gland","volume":"29","author":"Chawla","year":"2013","journal-title":"Ophthalmic Plastic & Reconstructive 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