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J Neurol Surg B Skull Base 2021; 82(01): 100-106
DOI: 10.1055/s-0040-1722700
Typical Orbital Pathologies
Review Article

Masses of the Lacrimal Gland: Evaluation and Treatment

Jane S. Kim
1   Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States
,
Jason Liss
1   Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States
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Abstract

Lacrimal gland lesions account for approximately 9 to 10% of all biopsied orbital masses. Potential causes include nongranulomatous and granulomatous inflammation, autoimmune disease, lymphoproliferative disorders, benign epithelial proliferation, malignant neoplasia, and metastatic disease. Inflammatory lesions and lymphoproliferative disorders are the most common and may be unilateral or bilateral; they may also be localized to the orbit or associated with systemic disease. Both benign and malignant epithelial lacrimal gland masses tend to be unilateral and involve the orbital lobe, but a more rapid onset of symptoms and periorbital pain strongly suggest malignant disease. On orbital imaging, both inflammatory and lymphoproliferative lesions conform to the globe and surrounding structures, without changes in adjacent bone, whereas epithelial lacrimal gland masses often show scalloping of the lacrimal gland fossa. Malignant epithelial lacrimal gland tumors can also have radiographic evidence of bony invasion and destruction. Masses of the lacrimal gland may be due to a broad range of pathologies, and a good working knowledge of common clinical characteristics and radiographic imaging findings is essential for diagnosis and treatment. All patients with inflammatory, lymphoproliferative, and epithelial neoplastic lesions involving the lacrimal gland require long-term surveillance for disease recurrence and progression.

Keywords

adenoid cystic carcinoma - dacryoadenitis - carcinoma ex pleomorphic adenoma - lacrimal gland mass - orbital lymphoma - orbital pseudotumor - pleomorphic adenoma - surgical debulking of lacrimal gland


Publication History

Article published online:
18 February 2021

© 2021. Thieme. All rights reserved.

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