Lacrimal gland pleomorphic adenoma: a review of 52 cases, 15-year experience

Abstract

Background: Lacrimal gland (LG) tumours are rare neoplasms. Pleomorphic adenoma (PA) is the most common histologic variant, representing ∼20% of all LG tumours. PA tends to recur leading to great morbidity.

Aims: We carried out this study to share our experience and provide recent data on the clinical aspects, radiologic findings, management and outcome after treatment.

Methods: We realised a hospital-based retrospective case review including data collected from 52 patients, managed over 15 years.

Results: The mean age was 39.8 ± 2 years. Unilateral painless proptosis was the most constant sign (51.9%). CT-scan showed predominantly isodense lesions (96.2%), with regular borders (94.2%), measuring on average 2 cm. MRI showed isointense lesions on T1-weighted images in 96.2% of cases. No pre-operative biopsy was done. Surgical management was mainly external lateral orbitotomy (94.2%). There was no recurrence, considering a mean follow-up period of 12.6 years. Size of tumour at the time of diagnosis increased with age (r = +0.36, p = .01).

Conclusions: Clinical and radiologic characteristics are consistent with literature. Older patients seem to present larger tumours. We believe that biopsy is not necessary if appropriate imaging is done. Complete, intact resection is generally sufficient to minimise the risk of recurrence.

Chinese abstract

背景：泪腺（LG）肿瘤是罕见的肿瘤。多形性腺瘤（PA）是最常见的组织变异, 占所有泪腺肿瘤的约20%。多形性腺瘤倾向于复发, 导致很高的发病率。

目的：我们进行这项研究的目的是, 分享我们的经验, 并提供有关临床方面、放射学发现、治疗后的管理和结果的最新数据。

方法：我们在医院进行了回顾性病例重审, 收集了52例15年以上的病例资料。

结果：平均年龄39.8±2岁。单侧无痛性眼球突出是最常见的征象（51.9%）。CT扫描以等密度病变为主（96.2%）, 边界规则（94.2%）, 平均大小为2cm。MRI表显示, 96.2%例的T1加权像上有 等强度病变。术前未做活检。手术主要以外侧眶外侧切开术为主（94.2%）。随访12.6年, 无复发。诊断时的肿瘤大小随年龄增长而增加（r = +0.36, p = .01）。

Keywords:

• Lacrimal gland
• pleomorphic adenoma
• X-Ray CT scan
• treatment outcome

Disclosure statement

The authors declare that there is no conflict of interest.