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Lacrimal gland pleomorphic adenoma and malignant epithelial tumours: clinical and imaging differences
  1. Stephanie Ming Young1,
  2. Yoon-Duck Kim2,
  3. Hyun Jin Shin3,
  4. Yukihiro Imagawa4,
  5. Stephanie S Lang5,
  6. Kyung In Woo2
  1. 1 Department of Ophthalmology, National University Hospital, Singapore
  2. 2 Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  3. 3 Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
  4. 4 Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
  5. 5 Clinical Audit, Singapore National Eye Centre, Singapore
  1. Correspondence to Dr Yoon-Duck Kim, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea; yoonduck.kim{at}samsung.com

Abstract

Aims To investigate the clinical and imaging features of primary and recurrent lacrimal gland pleomorphic adenoma (LGPA), as well as lacrimal gland malignant epithelial tumours (LGMET).

Methods Retrospective comparative case series from September 2000 to September 2016 in a single tertiary institution. Medical records of cases with histopathologically proven primary LGPA (PLGPA), recurrent LGPA (RLGPA) and LGMET were reviewed.

Results Sixty-four patients with LGPA (55 primary and nine recurrent) and 36 patients with LGMET underwent surgical excision in the study period. There was no significant difference in terms of age, gender or laterality. In terms of symptom duration, that of LGMET (7.1 months) was significantly shorter than PLGPA (23.9 months), which in turn was significantly shorter than RLGPA (127.1 months). Proptosis was the most common presenting symptom among all three groups. On CT, LGMET and RLGPA were significantly more likely to have ill-defined margins (p<0.001) and be heterogeneous (p<0.001) than PLGPA. RLGPAs (56%) were significantly more likely to have calcification than LGMET (34%), which in turn was more likely to have calcification than PLGPA (13%); LGMET (40%) and RLGPA (33%) were significantly more likely to have bony invasion than PLGPA (2.2%). On MRI, LGMETs (55%) were significantly more likely to have a tail or wedge sign indicating infiltration into the posterior orbit than PLGPA (0%) or RLGPA (0%).

Conclusion Our study adds important information regarding differentiating clinical and radiological features between malignant and benign epithelial lacrimal gland tumours that would aid in their management.

  • imaging
  • lacrimal gland
  • neoplasia
  • orbit

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Footnotes

  • Contributors All authors have made substantial contributions to the (1) conception of the work, (2) the acquisition, analysis or interpretation of data, (3) drafting the work or revising it critically for important intellectual content and (4) final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The manuscript has been read and approved by all the authors, and the requirements for authorship as stated have been met.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board: Samsung Medical Center Ethics Committee.

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

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