Residual glands were serous, and the majority of tumor cells were negative for mucin. Malignant tumors of the lacrimal gland include adenoid cystic carcinoma, adenocarcinoma, squamous cell carcinoma, mucoepidermoid carcinoma, and malignant lymphomas. Adenoid cystic carcinoma of lacrimal glands dr rohit sharma and dr maxime stamant et al. Lacrimal gland tumor an overview sciencedirect topics. 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. Lacrimal gland masses can be classified into two broad groups inflammatory 50% and neoplastic, either lymphoma 25% or salivary gland type tumors 25%. About salivary gland cancer what is salivary gland cancer. With a yearly incidence of one in one million, they represent only 10% of orbital spaceoccupying lesions. Lacrimal gland malignant mixed tumors carcinomas arising in benign mixed tumors. Having no signs of a tumor after finishing treatment. Because there is no specific histopathologic classification for lacrimal gland tumors, they are often classified according. 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. Hence, in many respects, lacrimal gland tumors resemble those that arise in the major salivary glands.
The most common epithelial tumor is a benign pleomorphic adenoma, accounting for half of all epithelial tumors. Multidisciplinary management of salivary gland cancers. The tumor is composed of cells of two types, some resembling luminal epithelial cells and the other resembling myoepithelial cells. When lacrimal gland cells change and grow uncontrollably, they form a mass called a tumor. 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.
Adenoid cystic carcinoma is the most common malignant lacrimal gland tumor. The overall incidence of salivary gland tumors varies around the world from approximately 0. Lacrimal gland tumors can be harmless or cancerous. Minor salivary gland carcinoma consider the lip and oral cavity, nasal. When lacrimal gland cells become abnormal and multiply, they form a growth of tissue called a tumor. It is located in the superolateral aspect of the orbit, abutting the superior rectus and lateral rectus muscles fig. Lacrimal gland tumors lgt are well known neoplasm affecting both the nictitating. Radiation oncologytoxicitylacrimal wikibooks, open books. Histologically, they are broadly characterized as epithelial and nonepithelial. Think of that menu as a roadmap to this full guide. Adenoid cystic carcinoma of the lacrimal gland simulating. Nov 21, 2019 tumors of the salivary glands account for only 24% of head and neck neoplasms. Pleormophic adenoma is the most common epithelial tumor of the lachrymal gland, accounting for 12% of all lachrymal gland lesions.
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%. 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. Pain is a sign of malignancy, but can also be in inflammatory processes. About 55% of epithelial lacrimal gland tumors are benign and 45% are malignant. Update from the 4th edition of the world health organization classification of head and neck tumours. Among malignant tumours originating in salivary glands and lacrimal glands, adenoid cystic carcinoma is seen most. 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. The anamnesis of the disease is shorter than in a benign tumor. A lacrimal gland tumor can be benign noncancerous or malignant cancerous, meaning it can spread to other parts of the body. Epithelial tumors of the lacrimal gland are generally seen in middleaged adults. Orbital adenocarcinoma of lacrimal gland origin in a dog. Codes and coding instructions 3rd edition, 1998 cancer. Pathology of mucous and salivary gland tumours in the lacrimal gland and the relation to extraorbital mucous and salivary gland tumours studies on orbital tumours3. They typically present as unilateral lacrimal gland enlargement with inferomedial displacement of the eye.
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. Adenoid cystic carcinoma of the lacrimal gland new york eye. Lymphoid tumors comprise 2035% and secondary tumors approximately 10%, with the remaining 10% being. Lacrimal gland tumors can be harmless benign or cancerous malignant. A pleomorphic adenoma of the lacrimal gland in a dog. Codes and coding instructions eod88 since it was first published. White, md, published an update of this classification, and adjusted the size of the lacrimal gland to the tnm classification of the salivary tumors. 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. The lacrimal gland is located under the outer part of each eyebrow. The lacrimal gland is considered to be a minor salivary gland that shares histologic features with the major salivary glands. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. Tumors of the lacrimal gland account for 10% of all spaceoccupying tumors of the orbit 1.
Pa is the most common salivary gland tumor and accounts for approximately 60% of all salivary gland neoplasms. A 28yearold man presented with an orbital tumour that was localized by computerized tomography to the fossa of the right lacrimal gland. Cancer of the lacrimal gland is manifested in 4 6 decades of life. The tumor is between 2 cm and 4 cm and likely extends to the orbital soft tissue. Cancer of the lacrimal gland competently about health on. Severe dry eye syndrome visual loss due secondary to corneal opacification, ulceration, or vascularization. Lacrimal gland tumors tumors of the lacrimal gland. Epithelial neoplasms are the most common followed by lymphoid. The tumor is 2 centimeters cm or smaller and may or may not extend outside of the lacrimal gland to the orbital soft tissue. The age of presentation of lacrimal gland tumors depends on the specific subtype of tumor, but overall these tumors can occur at any age. Lacrimal gland tumor information mount sinai new york.
It accounts for 25% of all epithelial lacrimal gland tumors. 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. Lacrimal gland tumor capt ayinun nahar trainee in ophthalmology cmh,dhaka 2. A benign tumor means the tumor can grow but will not spread.
Imaging features of malignant lacrimal sac and nasolacrimal. 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. 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. Minor salivary gland tumors msgts are infrequent, accounting for 1015% of all salivary neoplasms, and are fundamentally located in the palate 50%, lips 15%. They are a more common cause of a lacrimal sac mass than an inflammatory cause. Chronic swelling could be due to noninfectious inflammatory disorders such as thyroid eye disorder, sarcoidosis and orbital pseudotumor. Lacrimal gland lesions generally present as palpable masses in the superolateral aspects of the orbits. Contrary to previous belief, careful biopsy of the lacrimal gland prior. Most are epithelial in origin, with 50% benign and 50% malignant. Of the 120 lacrimal gland tumors, we focused on a detailed clinicopathologic study of 21 malignant epithelial tumors. It typically presents in adults between 3050 years old. The heterogeneity of salivary neoplasms represents a unique. The word survivorship means different things to different people.
They produce fluid that cleans and protects the surface of the eyelid. Epithelial tubules are disposed in an adenomatous fashion and separated from each other by proliferating myoepithelial cells. In an excisional biopsy, used more commonly for benign mixed epithelial tumors, the surgeon removes the entire tumor. 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. Tumor invades adjacent structures brain, sinus, pterygoid fossa or temporal fossa notes. The supraorbital location, encapsulation, and residual serous glands suggest that this mass was a lowgrade adenocarcinoma of the lacrimal gland. 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. Salivary gland neoplasm an overview sciencedirect topics. Pleomorphic adenocarcinoma malignant mixedcell tumor is represented by three main clinical options. The use of fine needle biopsy for a lacrimal gland tumor is controversial.
The main lacrimal gland is located in the upper temporal part of the orbit fig. You will find some basic information about this disease and the parts of the body it may affect. Feb 03, 2020 malignant tumors of the lacrimal gland include adenoid cystic carcinoma, adenocarcinoma, squamous cell carcinoma, mucoepidermoid carcinoma, and malignant lymphomas. Feb 03, 2020 the lacrimal gland is a bilobed eccrine secretory gland, which is situated in the superotemporal orbit. Contrary to previous belief, careful biopsy of the lacrimal. You have 2 lacrimal glands, one on each side above each eyeball, towards the outer part of the eyelid. Approximately 50% of lacrimal gland masses are inflammatory lesions, 25% are lymphoid lesions or lymphoma, and the other 25% are salivary gland type tumors. Tumors of the lacrimal gland constitute less than 5% of all biopsied orbital lesions 3, 4. If dose 57 gy, 100% and faster timetoonset 10 months. Lachrymal gland tumors are relatively rare, accounting for 56% of all intraorbital tumors.
Lacrimal gland primary epithelial tumors introduction. Pleomorphic adenoma pa was the most frequent benign tumor 68%, followed by warthin tumor 26%. As the maximum size of the lacrimal gland is 2 cm, t2 and greater tumors will usually extend into the orbital soft tissue. These tumors, when malignant, may spread across the other orbital compartments and related spaces. Lacrimal gland lesions have many similarities to those that occur in the major salivary glands. Malignant lacrimal gland tumors have recurrence rates of 52% to 63% and a metastasis rate of 26% to 50%. A lacrimal gland tumor is a tumor in one of the glands that produces tears. Benign epithelial tumors include lacrimal ductal cyst dacryops and pleomorphic adenoma pa. 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.
Primary lacrimal gland tumors arising from epithelial cells are relatively common, accounting for 20% of all solid lacrimal gland masses. In 1518 patients, tumor involved both the lacrimal sac and duct at the time of diagnosis. Sep 19, 2014 the most common benign and malignant epithelial tumors of the gland are the pleomorphic adenoma and adenoid cystic carcinoma, respectively. 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. The following sources were used in the development of this chapter. 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. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. A retrospective study of specific cases diagnosed as benign and malignant tumors of the minor salivary glands. The lacrimal gland may be thought of as a salivary gland when considering the likely etiology of a unilateral 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. Adenoid cystic carcinoma acc of the lacrimal glands is an extraconal malignancy usually originating from the orbital lobe of the lacrimal gland. Nasolacrimal tumors, in other words, tumors involving the nasolacrimal drainage apparatus are uncommon and have a variety of histologies. Among the epithelial lesions, 55% are benign and 45% are malignant 1.
Cancer of the lacrimal gland eye cancer cancer research uk. The tumor is greater than 4 cm and likely extends to the orbital soft tissue. 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. Tumors of the lacrimal gland have an estimated incidence of 1 per 1 million people per year. The following sources were used in the development of this schema seer extent of disease 1988. Pleomorphic adenoma with extensive ossified and calcified. There are four major types of lacrimal gland tumors.
Metastatic lacrimal gland tumor if a tumor has spread to another location in the body, it is called metastatic lacrimal gland tumor. Rbcp phleomorphic adenoma of the lachrymal gland case report. 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. 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. Characteristics of 5015 salivary gland neoplasms registered in the. This causes proptosis and, if enlargement of the gland is rapid, may even produce diplopia. The lacrimal gland is a bilobed eccrine secretory gland, which is situated in the superotemporal orbit.
You will read about how to cope with challenges in everyday life after a diagnosis of a lacrimal gland tumor. Recurrence is high if tumor cells spread during biopsy or incomplete resection. The following tumor types should not be reported using this protocol. Another characteristic of adenoid cystic carcinoma is that it also invades local nerves causing pain. The lacrimal gland consists of an orbital lobe figs.
When an adenoid cystic carcinoma of the lacrimal gland grows, it typically pushes the eye down, towards the nose and forward. Other tumors, including lymphoma, acinic cell carcinoma, oncocytoma, sebaceous carcinoma, solitary fibrous tumor, hemangioma, and warthins tumor may be encountered in this region. 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. 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. Computed tomography and magnetic resonance imaging are extremely useful for. Malignant epithelial tumors of the lacrimal gland account for 2% of all orbital eye socket tumors. Exclusion criteria included structural lesions dacryops and inflamma. 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. Build on previous arrocases for salivary gland 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. The most common tumor histology in our series was squamous cell carcinoma. Only 1 out of 1 million people are diagnosed with this type of tumor each year. Acute swelling is caused by a bacterial or viral infection such as mumps, epsteinbarr virus, gonococcus and staphylococcus.
Tumor invades periosteum or orbital bone or adjacent structures t4a. The lacrimal gland can be involved in a wide spectrum of orbital pathology. Recent findings debulking of the orbital lobe of the lacrimal gland may offer improved control rates in dacryoadenitis without compromise of tear film function. Overview of benign and malignant lacrimal gland tumors. The most common epithelial malignancy is primary adenoid cystic carcinoma. 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. In that regard, the tendencies for tumor involvement are most like the submandibular gland as opposed to the parotid gland. The submandibular glands are smaller and are below. The lacrimal gland is an almondshaped, eccrine secretory gland for tear production. Salivary gland tumors tehran university of medical sciences. Adenoid cystic carcinoma of lacrimal glands radiology. To see other pages, use the menu on the side of your screen. 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.
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