Epithelial tumours of the lacrimal gland

Abstract

Abstract Purpose To provide an overview of benign and malignant epithelial neoplasms arising in the lacrimal gland. Methods In the normal orbit, the lacrimal gland is clinically impalpable and is situated in the lacrimal fossa posterior to the superotemporal orbital rim. The gland is not truly encapsulated and is divided into the deep orbital and the superficial palpebral lobes by the levator aponeurosis. The retrospective study of 265 epithelial tumours of the lac¬rimal gland conducted by the Armed Forces Institute of Pa¬thology (AFIP) improved our understanding of the histologic classification and clinical behavior of epithelial tumours of the lacrimal gland. The historic works of Forrest (1954) and Zimmerman (1962) alleviated confu¬sion by applying to epithelial tumours of the lacrimal gland the histopathologic classification of salivary gland tumours. Epithelial tumours originating from the lacrimal gland should be staged according to the 7th Edition of the Tumor Node Metastasis (TNM) system, which is a modification of the World Health Organization (WHO) classification of salivary gland tumours. Results The most common benign epithelial tumour of the lacrimal gland is the pleomorphic adenoma. The most common lacrimal gland carcinomas include adenoid cystic carcinoma, “carcinoma ex pleomorphic adenoma”, primary adenocarcinoma & mucoepidermoid carcinoma. The regional lymph nodes include: preauricular, submandibular and cervical lymph nodes. The lung is the most common metastatic site, followed by bone and remote viscera. Conclusion Subtyping & grading of lacrimal gland epithelial tumours requires the latest WHO/AFIP classifications. Staging of these tumours should follow the 7th TNM system. Collection of datapoints is essential to identify biomarkers, which includes only nuclear N23 and MIB‐1 at present.