eMedicine Specialties > Ophthalmology > Lacrimal System

Lacrimal Gland Tumors: Follow-up

Author: Dan D DeAngelis, MD, FRCS(C), Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto
Coauthor(s): Noelene Pang, MD, Fellow in Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, University of Toronto; Jeff Hurwitz, MD, FRCS(C), Director of Ophthalmic Plastic Surgery, Ophthalmologist-in-Chief, Mount Sinai Hospital; Chairman, Professor, Department of Ophthalmology, University of Toronto, Canada
Contributor Information and Disclosures

Updated: Aug 8, 2006

Follow-up

Further Inpatient Care

  • Hospitalization may be required if treatment with chemotherapeutic agents is needed.

Prognosis

  • For pleomorphic adenomas, long-term studies reveal an increased incidence of malignant transformation (10% at 20 y and 20% at 30 y) associated with multiple recurrences for lesions that had frequent incisional biopsies and incomplete removal of the primary tumor.
  • Annual follow-up care is suggested to monitor the effects of treatment and to observe for recurrence or systemic involvement.
  • Systemic lymphoma develops in 20-30% of patients with malignant lymphoma of the lacrimal gland. Incidence is much higher if the initial presentation is with bilateral lacrimal gland involvement.
  • Adenoid cystic carcinomas carry a poorer prognosis because of bony extension and perineural infiltration.
    • These patients have a 50% at 5-year and 75% at 15-year mortality rate. Death commonly is due to intracranial spread and pulmonary metastasis.
    • Histologic pattern also is of prognostic significance with a cribriform pattern having a 70% at 5-year survival compared to a 20% at 5-year survival with a basaloid pattern.

Miscellaneous

Medicolegal Pitfalls

  • Early detection and treatment decreases the possibility of negative effects.
 


More on Lacrimal Gland Tumors

Overview: Lacrimal Gland Tumors
Differential Diagnoses & Workup: Lacrimal Gland Tumors
Treatment & Medication: Lacrimal Gland Tumors
Follow-up: Lacrimal Gland Tumors
References

References

  1. Esmaeli B, Ahmadi MA, Youssef A. Outcomes in patients with adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg. 2004;20:22-6. [Medline].

  2. Farmer JP, Lamba M, Lamba WR, et al. Lymphoproliferative lesions of the lacrimal gland: clinicopathological, immunohistochemical, and molecular genetic analysis. Can J Ophthalmol. 2005;40:151-60. [Medline].

  3. Font RL, Smith SL, Bryan RG. Malignant epithelial tumors of the lacrimal gland: A clinicopathological study of 21 cases. Arch Ophthalmol. 1998;116:613-6. [Medline].

  4. Forrest AW. Pathologic criteria for effective management of epithelial lacrimal gland tumors. Am J Ophthalmol. Jan 1971;1(1 Part 2):178-92. [Medline].

  5. Gamel JW, Font RL. Adenoid cystic carcinoma of the lacrimal gland: the clinical significance of a basaloid histologic pattern. Hum Pathol. Mar 1982;13(3):219-25. [Medline].

  6. Jakobiec FA, Yeo JH, Trokel SL, et al. Combined clinical and computed tomographic diagnosis of primary lacrimal fossa lesions. Am J Ophthalmol. Dec 1982;94(6):785-807. [Medline].

  7. Jenkins C, Rose GE, Bunce C, et al. Clinical features associated with survival of patients with lymphoma of the ocular adnexa. Eye. 2003;17:809-20. [Medline].

  8. Jones IS. Surgical considerations in the management of lacrimal gland tumors. Clin Plast Surg. Oct 1978;5(4):561-9. [Medline].

  9. Mafee MF, Edward DP, Koeller KK, Dorodi S. Lacrimal gland tumors and simulating lesions. Clinicopathologic and MR imaging features. Radiol Clin North Am. Jan 1999;37(1):219-39, xii. [Medline].

  10. Shields JA, Shields CL, Epstein JA, et al. Review: primary epithelial malignancies of the lacrimal gland: the 2003 Ramon L. Font lecture. Ophthal Plast Reconstr Surg. 2004;20:10-21. [Medline].

  11. Stewart WB, Krohel GB, Wright JE. Lacrimal gland and fossa lesions: An approach to diagnosis and management. Ophthalmol. 1979;86:886. [Medline].

  12. Wright JE, Stewart WB, Krohel GB. Clinical presentation and management of lacrimal gland tumors. Br J Ophthalmol. Sep 1979;63(9):600-6. [Medline].

Further Reading

Keywords

neoplastic lesion, orbital lobe, palpebral lobe, epithelial neoplasm

Contributor Information and Disclosures

Author

Dan D DeAngelis, MD, FRCS(C), Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto
Dan D DeAngelis, MD, FRCS(C) is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, California Medical Association, Canadian Medical Association, Canadian Ophthalmological Society, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Noelene Pang, MD, Fellow in Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, University of Toronto
Noelene Pang, MD is a member of the following medical societies: American Society of Ophthalmic Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Jeff Hurwitz, MD, FRCS(C), Director of Ophthalmic Plastic Surgery, Ophthalmologist-in-Chief, Mount Sinai Hospital; Chairman, Professor, Department of Ophthalmology, University of Toronto, Canada
Disclosure: Nothing to disclose.

Medical Editor

Jorge G Camara, MD, Chairman, Department of Ophthalmology and Otorhinolaryngology, Director of Fellowship Training Program, St Francis Medical Center; Associate Professor, Department of Surgery, University of Hawaii School of Medicine
Jorge G Camara, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Mark T Duffy, MD, PhD, Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal, and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic
Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience
Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting; Quest medical - lacrimal balloons Honoraria Speaking and teaching

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

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