Unveiling the Enigma: Gigantic primary de novo poorly-differentiated ductal adenocarcinoma of the lacrimal gland with aggressive features. A case report and literature review.

Abstract

Primary ductal adenocarcinoma (PDA) of the lacrimal gland is a rare and aggressive malignancy originating from ductal epithelial cells. Its rarity and diverse clinical presentations pose significant diagnostic challenges, emphasizing the need for accurate diagnosis and appropriate management strategies. The study presents an intriguing case of a 50-year-old man with a large de novo primary ductal adenocarcinoma of the lacrimal gland, initially misdiagnosed as a meningeal solitary fibrous tumor due to its atypical clinical presentation of "down and out" proptosis. The case underscores the importance of histopathology to achieve a correct diagnosis and guide management decisions. Despite aggressive treatment approaches, the prognosis of primary ductal adenocarcinoma patients remains grim due to its aggressive behavior and tendency for recurrence and metastasis. The present case study emphasizes that a differential of primary ductal adenocarcinoma should be considered despite the presence of anomalous clinical and radiological presentation.