Tumors of the Lacrimal Gland

Tumors of the Lacrimal Gland

Epidemiology: Tumors of the lacrimal gland account for 5 – 7% of orbital neo-plasms. Lacrimal gland tumors are much rarer in children (approximately 2% of orbital tumors). The relation of benign to malignant tumors of the lacrimal gland specified in the literature is 10:1. The most frequent benign epitheliallacrimal gland tumor is thepleomorphic adenoma. Malignant tumors include the adenoid cystic carcinoma and pleomorphic adenocarcinoma.

Etiology: The WHO classification of 1980 divides lacrimal gland tumors intothe following categories:

I. Epithelial tumors.

II. Tumors of the hematopoietic or lymphatic tissue.

III. Secondary tumors.

IV.Inflamed tumors.

V. Other and unclassified tumors.

Symptoms: Tumors usuallygrow very slowly. After a while, they displace theeyeball inferiorly and medially, which can cause double vision.

Diagnostic considerations: Testingmotilityprovides information about theinfiltration of the tumor into the extraocular muscles or mechanical changes in the eyeball resulting from tumor growth. The echogenicity of the tumor in ultrasound studies is an indication of its consistency. CT and MRI studiesshow the exact location and extent of the tumor. A biopsy will confirm whether it is malignant and what type of tumor it is.

Treatment: To the extent that this is possible, the entire tumor should beremoved; orbital exenteration (removal of the entire contents of the orbit) may be required. Systemic administration of corticosteroids is indicated for unspecific tumors.

Prognosis: This depends on the degree of malignancy of the tumor. Adenoidcystic carcinomas have the most unfavorable prognosis.