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