Tumors of the Lacrimal Gland

Epidemiology: Tumors of the lacrimal gland account for 5 - 7 % of orbital neoplasms. 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: l.The most frequent benign epithelial lacrimal gland tumor is the pleomorphic adenoma. Malignant tumors include the adenoid cystic carcinoma and pleomorphic adenocarcinoma.

Etiology: The WHO classification of 1980 divides lacrimal gland tumors into the 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 usually grow very slowly. After a while, they displace the eyeball inferiorly and medially, which can cause double vision.

Diagnostic considerations: Testing motility provides information about the infiltration 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 studies show 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 be removed; 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. Adenoid cystic carcinomas have the most unfavorable prognosis.

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