Combined Clinical and Computed Tomographic Diagnosis of Primary Lacrimal Fossa Lesions

“…Furthermore, in long-standing cases benign pleomorphic adenoma can lead to bone destruction [4]. A number of other benign and malignant lesions that can occur in the lacrimal gland fossa (including schwannoma, dermoid cysts, chronic idiopathic orbital inflammation and metastatic carcinoma) can also lead to bone destruction [3,5]. We realize that MRI is not the imaging method of choice to investigate bone change.…”

Section: Adjacent Bone Changementioning

confidence: 99%

“…The main outcome measures were anatomic extent, configuration, margins, angulation, internal features on T1-and T2-weighted images (with respect to extraocular muscles and cerebral gray matter), contrast enhancement of the lesion and adjacent bone change on MRI. Results: Of the 31 patients, 21 had chronic dacryoadenitis, 3 had lymphoid tumors, and 7 had epithelial tumors including pleomorphic adenoma (3), adenoid cystic carcinoma (3), and pleomorphic adenocarcinoma (1). The results of the patients with chronic dacryoadenitis demonstrated involvement of the orbital lobe alone in 13 patients (62%), involvement of both orbital and palpebral lobes in 8 (38%), a molded configuration with ill-defined margins, sharp angles in 13 (62%), round angles in 8 (38%), lack of bone change, an isointense internal signal on T1-weighted images, a hypointense signal on T2-weighted images, and moderate contrast enhancement.…”

mentioning

confidence: 99%

Magnetic resonance imaging of unilateral lacrimal gland lesions

Günduz

Shields

Günalp

et al. 2003

Graefe's Arch Clin Exp Ophthalmol

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It is difficult to uniformly correlate the MRI features and histopathologic findings in lacrimal gland lesions. However, MRI seems to be useful in determining the etiology of a unilateral lacrimal gland lesion. Internal tissue features on T1- and T2-weighted images of MRI are most helpful in categorizing these lesions. Although the number of patients is small, our findings suggest that there are differences in orbital MRI findings of inflammatory lesions and lymphoid tumors as compared to benign and malignant epithelial tumors in the lacrimal gland fossa.

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“…6 The long-term results for 30 previously reported patients,5 together with those for a further 48 patients, are described in this paper, and the efficiency of our earlier diagnostic algorithm4 is examined in relation to increased clinical and radiological experience. The results ofa modified surgical technique are also described.…”

Section: Introductionmentioning

confidence: 99%

Pleomorphic adenoma of the lacrimal gland.

Rose

Wright

1992

British Journal of Ophthalmology

173

142

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To reduce the risk of recurrence and malignant transformation, pleomorphic adenomas of the lacrimal gland should be removed intact, without prior biopsy. Seventy one of the 78 patients in this series were referred without previous surgery, and, on clinical or radiological evidence, 63 (89%) tumours were correctly diagnosed and totally excised, with preservation of a margin of the surrounding normal tissue. Sixty three patients had tumour within the body of the gland and 55 (84%) had radiological signs or satisfied clinical criteria for pleomorphic adenoma that we suggested previously; that is, over 1 year of symptoms and absence of pain. Eight (16%) orbital lobe tumours were misdiagnosed preoperatively and biopsied; in ali these patients symptoms had been present for less than 1 year, and four patients had pain. Eight patients with tumours arising in the palpebral lobe had a short history of an upper lid mass, and their tumours were excised without biopsy. With the surgical techniques described in this paper, there has been no recurrence of tumour in patients with follow-up as long as 21 years. A modification of surgical technique, with preservation of the palpebral lobe of the gland, has reduced the incidence of postoperative dry eye and distortion of the upper eyelid.Pleomorphic adenomas of the lacrimal gland have a high rate of recurrence if tumour cells are dispersed into the adjacent tissues during excision or biopsy,' and recurrence are often malignant.'-3 Ideally these tumours should be diagnosed on radiological and clinical evidence and biopsy avoided.An algorithm for the management of masses arising in the lacrimal gland fossa has been previously proposed by one of US.4S Highresolution computed tomography (CT) can help increase the proportion correctly diagnosed before surgery.6The long-term results for 30 previously reported patients,5 together with those for a further 48 patients, are described in this paper, and the efficiency of our earlier diagnostic algorithm4 is examined in relation to increased clinical and radiological experience. The results ofa modified surgical technique are also described.

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Combined Clinical and Computed Tomographic Diagnosis of Primary Lacrimal Fossa Lesions

Cited by 123 publications

References 18 publications

Primary Epithelial Malignancies of the Lacrimal Gland: The 2003 Ramon L. Font Lecture

Primary Epithelial Malignancies of the Lacrimal Gland: The 2003 Ramon L. Font Lecture

Magnetic resonance imaging of unilateral lacrimal gland lesions

Pleomorphic adenoma of the lacrimal gland.

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