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Lesions mimicking lacrimal gland pleomorphic adenoma
  1. Venkatesh C Prabhakaran1,
  2. Paul S Cannon1,
  3. Alan McNab2,
  4. Garry Davis1,
  5. Brett O'Donnell3,
  6. Peter J Dolman4,
  7. Raf Ghabrial5,
  8. Dinesh Selva1
  1. 1Discipline of Ophthalmology and Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, South Australia
  2. 2Royal Victoria Eye and Ear Hospital, Melbourne, Australia
  3. 3Royal North Shore Hospital, St Leonards, New South Wales, Australia
  4. 4University of British Columbia Eye Care Centre, Vancouver, Canada
  5. 5Sydney Eye Hospital, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Dinesh Selva, Discipline of Ophthalmology and Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Adelaide, SA 5000, Australia; eye{at}health.sa.gov.au

Abstract

Aim To report a series of patients with lacrimal gland lesions simulating the clinicoradiological features of lacrimal gland pleomorphic adenoma (LGPA).

Methods Multicentre retrospective, interventional case series. Clinical records of all patients with lesions mimicking LGPA seen in five orbital units were reviewed.

Results The study included 14 patients (seven men and seven women) with a mean age of 50.9 years. The diagnosis of LGPA was made in all cases by experienced orbital surgeons, based on clinicoradiological features, and lacrimal gland excision was performed. Postoperative histology revealed lymphoma (four patients), chronic dacryoadenitis (three patients), adenoid cystic carcinoma (two patients), Sjogren's syndrome (two patients), cavernous haemangioma (one patient), benign lymphoid hyperplasia (one patient) and granulomatous dacryoadenitis (one patient). Comparison with the total number of histologically confirmed LGPA cases seen during the study period revealed that 22.6% of cases of suspected LGPA were misdiagnosed based on clinicoradiological criteria.

Conclusions Many different lesions may mimic the clinicoradiological features of LGPA. The accepted clinicoradiological criteria used for the diagnosis of LGPA have a high false-positive rate, even in experienced hands. Based on this study, the authors believe that fine-needle aspiration biopsy or intraoperative biopsy and frozen section diagnosis may help reduce unnecessary lacrimal gland excision.

  • Lacrimal gland
  • mimics
  • neoplasia
  • pleomorphic adenoma
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Footnotes

  • Competing interests PSC received funding from the Royal College of Ophthalmologists, the Dickinson Trust, Pfizer and the Ethicon Foundation for Ophthalmic Fellowship training in Adelaide. These sponsors had no role in the design or conduct of this study.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Board/Ethics Committee approval was obtained for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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