Glaucoma · practice question
Which category of lesion do these features most suggest?
[READINESS SEED] An adult has a slowly enlarging, painless lacrimal-fossa mass present for more than a year; imaging shows smooth expansion of the bony fossa without destruction. Which category of lesion do these features most suggest?
Show the answer and explanationAnswer and explanation
Answer: A. A benign epithelial tumor
A painless mass of long duration (over a year) with smooth bony remodeling (not destruction) points to a benign epithelial tumor — the pleomorphic adenoma — whereas pain, a short history, and bone destruction indicate malignancy, and an acute painful course indicates inflammation. History and the bone pattern separate the categories and dictate whether to excise intact or biopsy.
Clinical pearl: The two key history questions — duration and pain — sort lacrimal-fossa masses into the "excise intact" benign epithelial group and the "biopsy" malignant/inflammatory group before imaging.