This was a retrospective study of all suspected epithelial tumors of the lacrimal gland surgically excised at king khaled eye specialist hospital kkesh for the period. Contrary to previous belief, careful biopsy of the lacrimal gland prior. The tumor is between 2 cm and 4 cm and likely extends to the orbital soft tissue. Pleormophic adenoma is the most common epithelial tumor of the lachrymal gland, accounting for 12% of all lachrymal gland lesions. A benign tumor means the tumor can grow but will not spread. Lacrimal gland malignant mixed tumors carcinomas arising in benign mixed tumors. Lacrimal gland tumors lgt are well known neoplasm affecting both the nictitating. Cancer of the lacrimal gland is manifested in 4 6 decades of life.
Lacrimal gland tumors are rare and constitute a wide spectrum of different entities ranging from benign epithelial and lymphoid lesions to highgrade carcinomas, lymphomas, and sarcomas with large. They typically present as unilateral lacrimal gland enlargement with inferomedial displacement of the eye. Lacrimal gland tumors can be harmless benign or cancerous malignant. Lacrimal gland lesions have many similarities to those that occur in the major salivary glands. Tumors of minor salivary glands e583 introduction salivary gland neoplasms represent less than 1% of all tumors, and 35% of all head and neck neoplasms. Multidisciplinary management of salivary gland cancers. White, md, published an update of this classification, and adjusted the size of the lacrimal gland to the tnm classification of the salivary tumors. Epithelial tumors of the lacrimal gland are generally seen in middleaged adults.
The following tumor types should not be reported using this protocol. Epithelial neoplasms are the most common followed by lymphoid. Minor salivary gland carcinoma consider the lip and oral cavity, nasal. Imaging features of malignant lacrimal sac and nasolacrimal. About 55% of epithelial lacrimal gland tumors are benign and 45% are malignant. A lacrimal gland tumor can be benign noncancerous or malignant cancerous, meaning it can spread to other parts of the body. While 915% of orbital tumors arise in lacrimal gland, inflammatory or infiltrative diseases such as sarcoidosis, wegeners granulomatosis, igg4 disease, or other nonspecific dacryoadenitis comprise twothirds of lacrimal gland masses and can present with signs and symptoms similar to tumors. Think of that menu as a roadmap to this full guide. Malignant epithelial tumors of the lacrimal gland account for 2% of all orbital eye socket tumors.
Lacrimal gland tumors occur in about 1 in 1,000,000 individuals per year and constitute 525% of all orbital malignancies 2,3, 5. Contrary to previous belief, careful biopsy of the lacrimal gland prior to excision does not appear to increase the risk of recurrence in cases with suspected pleomorphic adenoma. Minor salivary gland tumors msgts are infrequent, accounting for 1015% of all salivary neoplasms, and are fundamentally located in the palate 50%, lips 15%. Hence, in many respects, lacrimal gland tumors resemble those that arise in the major salivary glands. Feb 03, 2020 the lacrimal gland is a bilobed eccrine secretory gland, which is situated in the superotemporal orbit. A carcinoma arising in a pleomorphic adenoma is referred to as a carcinoma ex pleomorphic adenoma caexpa or a malignant mixed tumor and conveys a poor prognosis. The most common epithelial tumor is a benign pleomorphic adenoma, accounting for half of all epithelial tumors. Pain is a sign of malignancy, but can also be in inflammatory processes. Tumors of the lacrimal gland account for 10% of all spaceoccupying tumors of the orbit 1. Lacrimal gland tumors tumors of the lacrimal gland. Lachrymal gland tumors are relatively rare, accounting for 56% of all intraorbital tumors. Recurrence is high if tumor cells spread during biopsy or incomplete resection.
The heterogeneity of salivary neoplasms represents a unique. It typically presents in adults between 3050 years old. Because the lacrimal and salivary glands share similar characteristics, the american joint committee on cancer classification ajcc has aligned the classification with those of the salivary gland. It accounts for 25% of all epithelial lacrimal gland tumors. Another characteristic of adenoid cystic carcinoma is that it also invades local nerves causing pain. Lacrimal gland tumor an overview sciencedirect topics. A lacrimal gland tumor is a tumor in one of the glands that produces tears. A retrospective study of specific cases diagnosed as benign and malignant tumors of the minor salivary glands. Codes and coding instructions 3rd edition, 1998 cancer.
Lacrimal gland lesions represent 5% to 25% of orbital tumors, and the proportion in the literature that are epithelial range from 23% to 70% of biopsied cases. With a yearly incidence of one in one million, they represent only 10% of orbital spaceoccupying lesions. Adenoid cystic carcinoma of lacrimal glands radiology. The tumor is greater than 4 cm and likely extends to the orbital soft tissue. These tumors, when malignant, may spread across the other orbital compartments and related spaces. Histologically, they are broadly characterized as epithelial and nonepithelial.
The lacrimal gland may be thought of as a salivary gland when considering the likely etiology of a unilateral tumor. Lacrimal gland masses can be classified into two broad groups inflammatory 50% and neoplastic, either lymphoma 25% or salivary gland type tumors 25%. Salivary gland tumors tehran university of medical sciences. Pa is the most common salivary gland tumor and accounts for approximately 60% of all salivary gland neoplasms. Acute swelling is caused by a bacterial or viral infection such as mumps, epsteinbarr virus, gonococcus and staphylococcus. Lacrimal gland tumor capt ayinun nahar trainee in ophthalmology cmh,dhaka 2. Lowdose radiation 4 gy in two 2gy fractions appears to be effective and well tolerated in indolent nonhodgkin lymphoma of the ocular adnexa with high local control rate. Benign epithelial tumors include lacrimal ductal cyst dacryops and pleomorphic adenoma pa. Nov 21, 2019 tumors of the salivary glands account for only 24% of head and neck neoplasms. Lacrimal gland lesions generally present as palpable masses in the superolateral aspects of the orbits. The use of fine needle biopsy for a lacrimal gland tumor is controversial. The overall incidence of salivary gland tumors varies around the world from approximately 0. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. The symptoms and findings of a lacrimal gland lesion are a growing mass at the site of the lacrimal gland, including displacement of the eyeball.
Intoduction lacrimal gland tumors are rare, representing only 518% of orbital spaceoccupying lesions they have an estimated incidence of 1 per 1 million people per year they are more prevalent in elderly. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. Tumor invades periosteum or orbital bone or adjacent structures t4a. Contrary to previous belief, careful biopsy of the lacrimal. Verbist key points computed tomography and magnetic resonance imaging are in the critical pathway for evaluating the signs andor symptoms that are related to a lacrimal gland origin neoplasm. When lacrimal gland cells change and grow uncontrollably, they form a mass called a tumor. There are four major types of lacrimal gland tumors.
Adenoid cystic carcinoma is the most common primary malignant tumor of the lacrimal gland, but it accounts for less than 4% of all lacrimal gland lesions. It is located in the superolateral aspect of the orbit, abutting the superior rectus and lateral rectus muscles fig. A fine needle biopsy removes a small amount of tissue for examination under a microscope by inserting a needle directly into the tumor to extract cells. In 1518 patients, tumor involved both the lacrimal sac and duct at the time of diagnosis. The lacrimal gland can be involved in a wide spectrum of orbital pathology. The age of presentation of lacrimal gland tumors depends on the specific subtype of tumor, but overall these tumors can occur at any age. Exclusion criteria included structural lesions dacryops and inflamma. Tumors of the lacrimal gland constitute less than 5% of all biopsied orbital lesions 3, 4. About salivary gland cancer what is salivary gland cancer. Approximately 50% of lacrimal gland masses are inflammatory lesions, 25% are lymphoid lesions or lymphoma, and the other 25% are salivary gland type tumors. Having no signs of a tumor after finishing treatment.
If dose 57 gy, 100% and faster timetoonset 10 months. Codes and coding instructions eod88 since it was first published. Among the epithelial lesions, 55% are benign and 45% are malignant 1. Lacrimal gland tumors are rare and constitute a wide spectrum of different entities ranging from benign epithelial and lymphoid lesions to highgrade carcinomas, lymphomas, and sarcomas with large differences in prognosis and clinical management. You will read about how to cope with challenges in everyday life after a diagnosis of a lacrimal gland tumor.
In 1992, seer published the second edition, in which the most significant change from the first edition was that primary site codes were updated to the world health organizations international. Lacrimal gland tumor information mount sinai new york. When an adenoid cystic carcinoma of the lacrimal gland grows, it typically pushes the eye down, towards the nose and forward. Tumor invades adjacent structures brain, sinus, pterygoid fossa or temporal fossa notes. Tumors of the lacrimal gland have an estimated incidence of 1 per 1 million people per year. Lymphoid tumors comprise 2035% and secondary tumors approximately 10%, with the remaining 10% being. To see other pages, use the menu on the side of your screen. Radiation oncologytoxicitylacrimal wikibooks, open books. As the maximum size of the lacrimal gland is 2 cm, t2 and greater tumors will usually extend into the orbital soft tissue. Residual glands were serous, and the majority of tumor cells were negative for mucin.
Sep 19, 2014 the most common benign and malignant epithelial tumors of the gland are the pleomorphic adenoma and adenoid cystic carcinoma, respectively. Chronic swelling could be due to noninfectious inflammatory disorders such as thyroid eye disorder, sarcoidosis and orbital pseudotumor. Metastatic lacrimal gland tumor if a tumor has spread to another location in the body, it is called metastatic lacrimal gland tumor. Most 70% salivary gland tumors originate in the parotid gland, with the bulk of the remainder arising in the submandibular gland 8% and in the minor salivary glands 22%. Cancer of the lacrimal gland eye cancer cancer research uk. The most common tumor histology in our series was squamous cell carcinoma. The lacrimal gland is an almondshaped, eccrine secretory gland for tear production. Adenoid cystic carcinoma of the lacrimal gland simulating. Feb 03, 2020 malignant tumors of the lacrimal gland include adenoid cystic carcinoma, adenocarcinoma, squamous cell carcinoma, mucoepidermoid carcinoma, and malignant lymphomas. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Malignant tumors of the lacrimal gland include adenoid cystic carcinoma, adenocarcinoma, squamous cell carcinoma, mucoepidermoid carcinoma, and malignant lymphomas.
Most are epithelial in origin, with 50% benign and 50% malignant. Malignant lacrimal gland tumors have recurrence rates of 52% to 63% and a metastasis rate of 26% to 50%. The lacrimal gland consists of an orbital lobe figs. The purpose of this study was to present the imaging features of primary and secondary malignant lacrimal sac and nasolacrimal duct tumors and their pattern of tumor spread in 18 patients. Lacrimal gland tumors are considered one of the challenging types of tumor which are difficult to study because of their rare incidence as they represent almost only 10% of the space occupying orbital lesions. Salivary gland neoplasm an overview sciencedirect topics. The submandibular glands are smaller and are below. The 2 lobes of the lacrimal gland, the orbital lobe and the much smaller palpebral lobe, are separated anatomically by the lateral horn of the levator aponeurosis. The tumor is 2 centimeters cm or smaller and may or may not extend outside of the lacrimal gland to the orbital soft tissue. Only 1 out of 1 million people are diagnosed with this type of tumor each year. The lacrimal gland is considered to be a minor salivary gland that shares histologic features with the major salivary glands.
Because there is no specific histopathologic classification for lacrimal gland tumors, they are often classified according. The tumor is composed of cells of two types, some resembling luminal epithelial cells and the other resembling myoepithelial cells. The word survivorship means different things to different people. They are a more common cause of a lacrimal sac mass than an inflammatory cause. Primary lacrimal gland tumors arising from epithelial cells are relatively common, accounting for 20% of all solid lacrimal gland masses. Orbital adenocarcinoma of lacrimal gland origin in a dog. Build on previous arrocases for salivary gland tumors. You have 2 lacrimal glands, one on each side above each eyeball, towards the outer part of the eyelid. The lacrimal gland is located under the outer part of each eyebrow. The lacrimal gland is a bilobed eccrine secretory gland, which is situated in the superotemporal orbit. The anamnesis of the disease is shorter than in a benign tumor. When lacrimal gland cells become abnormal and multiply, they form a growth of tissue called a tumor.
Of the 120 lacrimal gland tumors, we focused on a detailed clinicopathologic study of 21 malignant epithelial tumors. Computed tomography and magnetic resonance imaging are extremely useful for. Patients with pleomorphic adenoma and adenoid cystic carcinoma have a mean age at diagnosis of 40 years, whereas individuals with other forms of carcinoma have a mean age of 50 years. They produce fluid that cleans and protects the surface of the eyelid. The following sources were used in the development of this schema seer extent of disease 1988. Severe dry eye syndrome visual loss due secondary to corneal opacification, ulceration, or vascularization. Recent findings debulking of the orbital lobe of the lacrimal gland may offer improved control rates in dacryoadenitis without compromise of tear film function. Pleomorphic adenoma with extensive ossified and calcified. Lacrimal gland tumors can be harmless or cancerous. Nasolacrimal tumors, in other words, tumors involving the nasolacrimal drainage apparatus are uncommon and have a variety of histologies.
Adenoid cystic carcinoma is the most common malignant lacrimal gland tumor, comprising 50% of malignant tumors of lacrimal gland and 25% of all lacrimal gland tumors. Adenoid cystic carcinoma of the lacrimal gland new york eye. Lacrimal gland primary epithelial tumors introduction. Pleomorphic adenoma pa was the most frequent benign tumor 68%, followed by warthin tumor 26%. Characteristics of 5015 salivary gland neoplasms registered in the. Adenoid cystic carcinoma of lacrimal glands dr rohit sharma and dr maxime stamant et al.
The supraorbital location, encapsulation, and residual serous glands suggest that this mass was a lowgrade adenocarcinoma of the lacrimal gland. In that regard, the tendencies for tumor involvement are most like the submandibular gland as opposed to the parotid gland. Lacrimal gland lesions a variety of neoplasms and related lesions can arise in the lacrimal gland 1,2,3,4,5,6,7,8,9,10,11,12. Update from the 4th edition of the world health organization classification of head and neck tumours. The most common epithelial malignancy is primary adenoid cystic carcinoma.
Other tumors, including lymphoma, acinic cell carcinoma, oncocytoma, sebaceous carcinoma, solitary fibrous tumor, hemangioma, and warthins tumor may be encountered in this region. Pleomorphic adenocarcinoma malignant mixedcell tumor is represented by three main clinical options. Epithelial tubules are disposed in an adenomatous fashion and separated from each other by proliferating myoepithelial cells. You will find some basic information about this disease and the parts of the body it may affect. Among malignant tumours originating in salivary glands and lacrimal glands, adenoid cystic carcinoma is seen most. Adenoid cystic carcinoma acc of the lacrimal glands is an extraconal malignancy usually originating from the orbital lobe of the lacrimal gland. A 28yearold man presented with an orbital tumour that was localized by computerized tomography to the fossa of the right lacrimal gland. The main lacrimal gland is located in the upper temporal part of the orbit fig. A, a 41yearold male presented with a slight fullness of the right upper eyelid arrow and displacement of the right eye developing over 6 months. Cancer of the lacrimal gland competently about health on. This causes proptosis and, if enlargement of the gland is rapid, may even produce diplopia. Overview of benign and malignant lacrimal gland tumors. Adenoid cystic carcinoma is the most common malignant lacrimal gland tumor. The following sources were used in the development of this chapter.
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