Clinical characteristics and methods of extirpating surgery of 96 cases with lacrimal gland pleomorphic adenoma

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Objective To investigate the clinical characteristics and extirpating surgery for lacrimal gland pleomorphic adenoma. Methods Ninty-six cases of benign pleomorphic adenoma of lacrimal gland were retrospectively studied. The clinical characteristics, extirpating procedure and postoperative recurrence were analyzed. Results All of the patients were confirmed pleomorphic adenoma of lacrimal gland by the pathological examination after the surgery. Of all 96 cases, 74 cases were primary ones and 22 cases were recurrent ones. The common symptoms and signs of primary pleomorphic adenoma were exophthalmos (56 cases, 75.7%), ectopia bulbi (40 cases, 54.1%), limitation of eyeball movement (37 cases, 50.0%), decreased visual acuity (9 cases, 12.2%), diplopia (4 cases, 5.4%) and pain (3 cases, 4.1%). The common symptoms and signs of recurrent pleomorphic adenoma were exophthalmos (16 cases, 72.7%), ectopia bubli (13 cases, 59.1%), decreased visual acuity (9 cases , 40.9%), limitation of eyeball movement (7 cases, 31.8%), diplopia (6 cases, 27.3%) and pain (4 cases, 18.2%). The patients were followed up for 3-10 years. In the 74 primary cases, 1 case recurred (1.4%). In the 22 recurrent cases, 3 cases recurred (13.6%), 2 cases had malignant change (9.1%), 1 case died (4.5%), and 2 cases were lost to follow-up (9.1%). Conclusion Before the operation for lacrimal gland pleomorphic adenoma, the tumor should be accurately located. The size, boundary, range, texture and the relationship with the surrounding tissue should be carefully studied for selecting the reasonable surgical procedure. The biopsy should be avoided. Key words: Lacrimal gland; Pleomorphic adenoma; Clinical observation