Pleomorphic adenoma is the most common epithelial tumour of the lacrimal gland, representing 12% of lacrimal fossa lesions.¹ It typically presents in middle age and is rare in children under the age of 16 years, with only a few previously reported cases.^2–6 We present an additional case in a 10 year old girl with photographic documentation of longstanding orbital asymmetry.

Pleomorphic adenoma of the lacrimal gland is rare in children with only few previously reported cases. Nevertheless, even in the paediatric age group, it is important to consider the diagnosis in the presence of a painless, gradually progressive lacrimal gland mass. A published system for evaluation of lacrimal gland masses scores the duration of symptoms, presence of persistent pain or sensory loss, as well as radiological features, in order to determine the appropriate surgical management.⁷ The case described scored the maximum 8 points, where a score higher than 3 suggests pleomorphic adenoma requiring excision without previous incisional biopsy. Complete excision with an intact pseudocapsule has prognostic importance in avoiding later pervasive recurrence and malignant transformation.