To review reports of adenoid cystic carcinomas arising in the head and neck area outside of the major salivary glands, in order to enhance the care of patients with these unusual neoplasms.

An international team of head and neck surgeons, pathologists, oncologists and radiation oncologists was assembled to explore the published experience and their own working experience of the diagnosis and treatment of adenoid cystic carcinomas arising in the vicinity of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal.

The behaviour of adenoid cystic carcinoma arising in head and neck sites exclusive of the major salivary glands parallels that of tumours with a similar histology arising in the major salivary glands – these are relentless, progressive tumours, associated with high rates of mortality. Of 774 patients reviewed, at least 41 (5.3 per cent) developed documented regional node metastases.

The relatively low overall incidence of nodal metastases in adenoid cystic carcinomas arising in the head and neck region outside of the major salivary glands suggests that routine elective regional lymph node dissection might not be indicated in most patients with these tumours.

Periorbital cellulitis secondary to rhinosinusitis is common. However, very rarely this can be complicated by a lacrimal gland abscess. We report such a case.

We present a case report and literature review concerning lacrimal gland abscess secondary to periorbital cellulitis.

Due to the location of this condition, prompt assessment and management is vital to avoid potential ophthalmological and neurological complications. Our patient failed to respond to initial conservative medical treatment, and was subsequently identified as having a lacrimal gland abscess, confirmed on contrast-enhanced computed tomography. Following definitive surgical treatment, the patient's clinical course improved. This case furthers our knowledge of this condition, and adds to the two previously reported paediatric cases.

This case emphasises the importance of prompt management, and the fact that failure of clinical improvement following orbital decompression should alert the clinician to the rare possibility of an associated lacrimal gland abscess. The case also emphasises the key role of imaging and a multidisciplinary team approach when managing this condition.