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Orbital lobe resection provides a definite diagnosis of lacrimal gland lesions: a report of three cases

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Abstract

Background

Entities of lacrimal gland lesions comprise almost inflammatory and lymphoproliferative processes as well as benign and malignant solid tumors and usually cannot be differentiated by magnetic resonance imaging (MRI) exclusively. Hence, representative tissue samples are needed to arrive at sufficient histopathological diagnosis for further treatment decisions.

Case report

Three women aged between 18 and 67 years were admitted to our center with clinical signs of a space-occupying mass in the lacrimal fossa. MRI revealed a circumscribed lacrimal gland lesion in all three cases. The orbital lobe was resected through a lateral orbitotomy approach for histopathological evaluation. Findings confirmed the diagnoses of pleomorphic adenoma, dacryoadenitis, and low-grade B cell non-Hodgkin’s lymphoma. Further surgery was not necessary. No recurrence or symptoms of “dry eye” were observed over the course of a 1-year follow-up.

Conclusion

In cases of non-specific masses in the lacrimal gland on MRI, histopathological diagnoses are vital and can be sufficiently provided by resection of the orbital lobe. Symptoms of dry eye are uncommon, and secondary surgical intervention can be avoided in cases of the presented entities. Further studies with larger patient cohorts are warranted to confirm these findings.

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References

  1. Teo L, Seah LL, Choo CT, Chee SP, Chee E, Looi A (2013) A survey of the histopathology of lacrimal gland lesions in a tertiary referral centre. Orbit 32:1–7

    Article  PubMed  Google Scholar 

  2. Shields CL, Shields JA, Eagle RC, Rathmell JP (1989) Clinicopathologic review of 142 cases of lacrimal gland lesions. Ophthalmology 96:431–435

    Article  CAS  PubMed  Google Scholar 

  3. Von Holstein SL, Coupland SE, Briscoe D, Le Tourneau C, Heegaard S (2013) Epithelial tumours of the lacrimal gland: a clinical, histopathological, surgical and oncological survey. Acta Ophthalmol 91:195–206

    Article  Google Scholar 

  4. Andrew NH, McNab AA, Selva D (2015) Review of 268 lacrimal gland biopsies in an Australian cohort. Clin Experiment Ophthalmol 43:5–11

    Article  PubMed  Google Scholar 

  5. Jung WS, Kook JA, Park MR, Kim JY, Choi JJ, Kim BS, Hahn ST (2007) The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa. Korean J Radiol 8:336–342

    Article  PubMed Central  PubMed  Google Scholar 

  6. Eldesouky MA, Elbakary MA, Sabik S, Shareef MM (2014) Lacrimal fossa lesions: a review of 146 cases in Egypt. Clin Ophthalmol 8:1603–1609

    PubMed Central  PubMed  Google Scholar 

  7. Schmidt RL, Factor RE, Affolter KE, Cook JB, Hall BJ, Narra KK, Witt BL, Wilson AR, Layfield LJ (2012) Methods specification for diagnostic test accuracy studies in fine-needle aspiration cytology: a survey of reporting practice. Am J Clin Pathol 137:132–141

    Article  PubMed  Google Scholar 

  8. Howlett DC, Skelton E, Moody A (2015) Re: Fakhry et al., fine needle aspiration cytology and frozen section in the diagnosis of malignant parotid tumours. Int J Oral Maxillofac Surg 44:139–140

    Article  CAS  PubMed  Google Scholar 

  9. Pakdaman MN, Sepahdari AR, Elkhamary SM (2014) Orbital inflammatory disease: pictorial review and differential diagnosis. World J Radiol 28:106–115

    Article  Google Scholar 

  10. Mizokami H, Inokuchi A, Sawatsubashi M, Takagi S, Tsuda K, Tokunaga O (2002) Adenoid cystic carcinoma of the lacrimal gland with wide and severe myoepithelial differentiation. Auris Nasus Larynx 29:77–82

    Article  PubMed  Google Scholar 

  11. Friedrich RE, Bleckmann V (2003) Adenoid cystic carcinoma of salivary and lacrimal gland origin: localization, classification, clinical pathological correlation, treatment results and long-term follow-up control in 84 patients. Anticancer Res 23:931–940

    PubMed  Google Scholar 

  12. Halli RC, Mishra S, Kini YK, Kharkar VR, Hebbale MA (2011) Modified lateral orbitotomy approach: a novel technique in the management of lacrimal gland tumors. J Craniofac Surg 22:1035–1038

    Article  PubMed  Google Scholar 

  13. Ogawa Y, Kuwana M (2003) Dry eye as a major complication associated with chronic graft-versus-host disease after hematopoietic stem cell transplantation. Cornea 22:S19–27

    Article  PubMed  Google Scholar 

  14. Sullivan BD, Crews LA, Messmer EM, Foulks GN, Nichols KK, Baenninger P, Geerling G, Figueiredo F, Lemp MA (2014) Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: clinical implications. Acta Ophthalmol 92:161–166

    Article  PubMed  Google Scholar 

  15. Ducasse A (2007) Surgical orbital anatomy. In: Guthoff R, Katowitz J (eds) Oculoplastics and orbit. Springer, Heidelberg, pp 73–97

    Google Scholar 

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Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany

    Christina Schnabl, Christian Kühn & Jan Rustemeyer

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  1. Christina Schnabl
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  2. Christian Kühn
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  3. Jan Rustemeyer
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Correspondence to Jan Rustemeyer.

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Schnabl, C., Kühn, C. & Rustemeyer, J. Orbital lobe resection provides a definite diagnosis of lacrimal gland lesions: a report of three cases. Oral Maxillofac Surg 19, 433–436 (2015). https://doi.org/10.1007/s10006-015-0514-5

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  • DOI: https://doi.org/10.1007/s10006-015-0514-5

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