Lacrimal Gland Tumors

  • Brent HayekEmail author
  • Bita Esmaeli
Part of the M.D. Anderson Solid Tumor Oncology Series book series (MDA, volume 6)


This chapter outlines the clinical presentation and management of tumors that affect the lacrimal gland. Lacrimal gland tumors can be categorized as lymphoproliferative lesions, benign epithelial tumors, and malignant epithelial tumors. Lymphomas are the most common primary cancers of the orbit in adults, and the lacrimal gland is a frequent site of involvement. Benign epithelial tumors of the lacrimal gland include pleomorphic adenomas, oncocytomas, and spindle cell myoepitheliomas. Adenoid cystic carcinoma is the most common primary malignant epithelial tumor of the lacrimal gland; others include mixed tumor, adenocarcinoma, mucoepidermoid carcinoma, squamous cell carcinoma, oncocytoma, and acinic cell carcinoma. The American Joint Committee on Cancer staging system, which is used to classify many malignant epithelial tumors of the head and neck, can provide objective criteria for staging of lacrimal gland tumors. Because tumor stage at presentation may be associated with prognosis, it should be considered when treatment is planned.


Adenoid Cystic Carcinoma Pleomorphic Adenoma Lacrimal Gland Mucoepidermoid Carcinoma Acinic Cell Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Wright JE, Rose GE, Garner A. Primary malignant neoplasms of the lacrimal gland. Br J Ophthalmol 1992;76(7):401–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Ashton N. Epithelial tumours of the lacrimal gland. Mod Probl Ophthalmol 1975;14:306–23.PubMedGoogle Scholar
  3. 3.
    Garrity JA, Henderson JW, Cameron JD. Primary epithelial neoplasms. In: Henderson’s Orbital Tumors, fourth edition. Philadelphia, PA: Lippincott, Williams & Wilkins, 2007:279–96.Google Scholar
  4. 4.
    Lazzarino M, Morra E, Rosso R, et al. Clinicopathologic and immunologic characteristics of non-Hodgkin’s lymphomas presenting in the orbit. A report of eight cases. Cancer 1985;55(9):1907–12.PubMedCrossRefGoogle Scholar
  5. 5.
    Shields CL, Shields JA, Eagle RC, et al. Clinicopathologic review of 142 cases of lacrimal gland lesions. Ophthalmology 1989;96(4):431–5.PubMedGoogle Scholar
  6. 6.
    Hurwitz JJ. A practical approach to the management of lacrimal gland lesions. Ophthalmic Surg 1982;13(10):829–36.PubMedGoogle Scholar
  7. 7.
    Jung WS, Ahn KJ, Park MR, et al. The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa [review]. Korean J Radiol 2007;8(4):336–42.PubMedCrossRefGoogle Scholar
  8. 8.
    Lemke AJ, Hosten N, Grote A, et al. Differentiation of lacrimal gland tumors with high resolution computerized tomography in comparison with magnetic resonance tomography [in German]. Ophthalmology 1996;93(3):284–91.Google Scholar
  9. 9.
    Gündüz K, Shields CL, Günalp I, et al. Magnetic resonance imaging of unilateral lacrimal gland lesions. Graefes Arch Clin Exp Ophthalmol 2003;241(11):907–13.PubMedCrossRefGoogle Scholar
  10. 10.
    Ellis JH, Banks PM, Campbell RJ, et al. Lymphoid tumors of the ocular adnexa. Clinical correlation with the working formulation classification and immunoperoxidase staining of paraffin sections. Ophthalmology 1985;92(10):1311–24.PubMedGoogle Scholar
  11. 11.
    Esik O, Ikeda H, Mukai K, et al. A retrospective analysis of different modalities for treatment of primary orbital non-Hodgkin’s lymphomas. Radiother Oncol 1996;38(1):13–18.PubMedCrossRefGoogle Scholar
  12. 12.
    Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29(1):252–60.PubMedCrossRefGoogle Scholar
  13. 13.
    Jakobiec FA, Font RL. Lymphoid tumors. In: Spencer WH, editor. Ophthalmic Pathology: An Atlas and Textbook. Philadelphia, PA: WB Saunders, 1986:2663–712.Google Scholar
  14. 14.
    White V, Rootman J, Quenville N, et al. Orbital lymphoproliferative and inflammatory lesions. Can J Ophthalmol 1987;22(7):362–73.PubMedGoogle Scholar
  15. 15.
    Hatef E, Roberts D, McLaughlin P, et al. Prevalence and nature of systemic involvement and stage at initial examination in patients with orbital and ocular adnexal lymphoma. Arch Ophthalmol 2007;125(12):1663–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Gayed I, Eskandari MF, McLaughlin P, et al. Value of positron emission tomography in staging ocular adnexal lymphomas and evaluating their response to therapy. Ophthalmic Surg Lasers Imaging 2007;110:809–15.Google Scholar
  17. 17.
    The Non-Hodgkin’s Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. Blood 1997;89(11):3909–18.Google Scholar
  18. 18.
    Yeo JH, Jakobiec FA, Abbott GF, et al. Combined clinical and computed tomographic diagnosis of orbital lymphoid tumors. Am J Ophthalmol 1982;94(2):235–45.PubMedGoogle Scholar
  19. 19.
    Font RL, Gamel JW. Epithelial tumors of the lacrimal gland: analysis of 265 cases. In: Jakobiec FA, editor. Ocular and Adnexal Tumors. Birmingham: Aesculapius, 1978:787–805.Google Scholar
  20. 20.
    Sanders TE. Mixed tumor of the lacrimal gland. Arch Ophthalmol 1939;21:239–60.CrossRefGoogle Scholar
  21. 21.
    Faktorovich EG, Crawford JB, Char DH, et al. Benign mixed tumor (pleomorphic adenoma) of the lacrimal gland in a 6-year-old boy. Am J Ophthalmol 1996;122(3):446–7.PubMedGoogle Scholar
  22. 22.
    Vagefi MR, Hong JE, Zwick OM, et al. Atypical presentations of pleomorphic adenoma of the lacrimal gland. Ophthal Plast Reconstr Surg 2007;23(4):272–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Ramlee N, Ramli N, Tajudin LS. Pleomorphic adenoma in the palpebral lobe of the lacrimal gland misdiagnosed as chalazion. Orbit 2007;26(2):137–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Halhal M, Meyer A, Morel X, et al. Pleomorphic adenoma mimicking dacryoadenitis [in French]. J Fr Ophthalmol 2004;27(10):1200–3.CrossRefGoogle Scholar
  25. 25.
    Stefko ST, DiBernardo C, Green WR, et al. Pleomorphic adenoma of the lacrimal gland with extensive calcification. Arch Ophthalmol 2004;122(5):778–80.PubMedCrossRefGoogle Scholar
  26. 26.
    Jakobiec FA, Font RL. Lacrimal gland tumors. In: Spencer WH, editor. Ophthalmic Pathology: An Atlas and Textbook. Philadelphia, PA: WB Saunders, 1986:2496–525.Google Scholar
  27. 27.
    Grossniklaus HE, Abbuhl MF, McLean IW. Immunohistologic properties of benign and malignant mixed tumor of the lacrimal gland. Am J Ophthalmol 1990;110(5):540–9.PubMedGoogle Scholar
  28. 28.
    Tosaka Y. Immunohistochemical study of pleomorphic adenoma of lacrimal gland. Jpn J Ophthalmol 1991;35(4):367–76.PubMedGoogle Scholar
  29. 29.
    Nakazato Y, Ishizeki J, Takahashi K, et al. Localization of S-100 protein and glial fibrillary acidic protein-related antigen in pleomorphic adenoma of the salivary glands. Lab Invest 1982;46(6):621–6.PubMedGoogle Scholar
  30. 30.
    Stead RH, Qizilbash AH, Kontozoglou T, et al. An immunohistochemical study of pleomorphic adenomas of the salivary gland: glial fibrillary acidic protein-like immunoreactivity identifies a major myoepithelial component. Hum Pathol 1988;19(1):32–40.PubMedCrossRefGoogle Scholar
  31. 31.
    Wright JE, Stewart WB, Krohel GB. Clinical presentation and management of lacrimal gland tumours. Br J Ophthalmol 1979;63(9):600–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Wright JE. Factors affecting the survival of patients with lacrimal gland tumours. Can J Ophthalmol 1982;17(1):3–9.PubMedGoogle Scholar
  33. 33.
    Stewart WB, Krohel GB, Wright JE. Lacrimal gland and fossa lesions: an approach to diagnosis and management. Ophthalmology 1979;86(5):886–95.PubMedGoogle Scholar
  34. 34.
    Rose GE, Wright JE. Pleomorphic adenoma of the lacrimal gland. Br J Ophthalmol 1992;76(7):395–400.PubMedCrossRefGoogle Scholar
  35. 35.
    Ni C, Cheng SC, Dryja TP, et al. Lacrimal gland tumors: a clinicopathological analysis of 160 cases. Int Ophthalmol Clin 1982;22(1):99–120.PubMedCrossRefGoogle Scholar
  36. 36.
    Currie ZI, Rose GE. Long-term risk of recurrence after intact excision of pleomorphic adenomas of the lacrimal gland. Arch Ophthalmol 2007;125(12):1643–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Biggs SL, Font RL. Oncocytic lesions of the caruncle and other ocular adnexa. Arch Ophthalmol 1977;95(3):474–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Riedel K, Stefani FH, Kampik A. Oncocytoma of the ocular adnexa [in German]. Klin Monatsbl Augenheilkd 1983;182(6):544–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Calle CA, Castillo IG, Eagle RC, et al. Oncocytoma of the lacrimal gland: case report and review of the literature. Orbit 2006;25:243–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Eglen DE. Ocular adnexal oncocytoma. Am J Clin Pathol 1982;78:566–8.PubMedGoogle Scholar
  41. 41.
    Economou MA, Seregard S, Sahlin S. Oncocytoma of the lacrimal gland. Acta Ophthalmol Scand 2007;85(5):576–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Heathcote JG, Hurwitz JJ, Dardick I. A spindle-cell myoepithelioma of the lacrimal gland. Arch Ophthalmol 1990;108(8):1135–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Font RL, Garner A. Myoepithelioma of the lacrimal gland: report of a case with spindle cell morphology. Br J Ophthalmol 1992;76(10):634–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Grossniklaus HE, Wojno TH, Wilson MW, et al. Myoepithelioma of the lacrimal gland. Arch Ophthalmol 1997;115(12):1588–90.PubMedCrossRefGoogle Scholar
  45. 45.
    Font RL, Smith SL, Bryan RG. Malignant epithelial tumors of the lacrimal gland: a clinicopathologic study of 21 cases. Arch Ophthalmol 1998;116(5):613–6.PubMedGoogle Scholar
  46. 46.
    Lorenz B, Stefani FH, Theopold M. Local excision of an adenoid cystic carcinoma of the lacrimal gland in a 12-year-old girl: case report (author’s translation) [in German]. Klin Monatsbl Augenheilkd 1982;180(2):164–5.PubMedCrossRefGoogle Scholar
  47. 47.
    Galliani CA, Faught PR, Ellis FD. Adenoid cystic carcinoma of the lacrimal gland in a six-year-old girl. Pediatr Pathol 1993;13(5):559–65.PubMedCrossRefGoogle Scholar
  48. 48.
    Tellado MV, McLean IW, Specht CS, et al. Adenoid cystic carcinomas of the lacrimal gland in childhood and adolescence. Ophthalmology 1997;104(10):1622–5.PubMedGoogle Scholar
  49. 49.
    Shields JA, Shields CL, Eagle RC Jr, et al. Adenoid cystic carcinoma of the lacrimal gland simulating a dermoid cyst in a 9-year-old boy. Arch Ophthalmol 1998;116(12):1673–6.PubMedGoogle Scholar
  50. 50.
    Boitte JP, Traoré J, Boukhet F, et al. Adenoid cystic carcinoma of the lacrimal gland in a 14-year-old girl [in French]. J Fr Ophthalmol 2006;29(8):937–40.CrossRefGoogle Scholar
  51. 51.
    Gamel JW, Font RL. Adenoid cystic carcinoma of the lacrimal gland: the clinical significance of a basaloid histologic pattern. Hum Pathol 1982;13:219–25.PubMedCrossRefGoogle Scholar
  52. 52.
    Lee DA, Campbell RJ, Waller RR, et al. A clinicopathologic study of primary adenoid cystic carcinoma of the lacrimal gland. Ophthalmology 1985;92(1):128–34.PubMedGoogle Scholar
  53. 53.
    Esmaeli B, Golio D, Kies M, et al. Surgical management of locally advanced adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg 2006;22(5):366–70.PubMedCrossRefGoogle Scholar
  54. 54.
    Esmaeli B, Ahmadi MA, Youssef A, et al. Outcomes in patients with adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg 2004;20(1):22–6.PubMedCrossRefGoogle Scholar
  55. 55.
    Meldrum ML, Tse DT, Benedetto P. Neoadjuvant intracarotid chemotherapy for treatment of advanced adenocystic carcinoma of the lacrimal gland. Arch Ophthalmol 1998;116(3):315–21.PubMedGoogle Scholar
  56. 56.
    Tse DT, Benedetto P, Dubovy S, et al. Clinical analysis of the effect of intraarterial cytoreductive chemotherapy in the treatment of lacrimal gland adenoid cystic carcinoma. Am J Ophthalmol 2006;141(1):44–53.PubMedCrossRefGoogle Scholar
  57. 57.
    Henderson JW, Neault RW. En bloc removal of intrinsic neoplasms of the lacrimal gland. Am J Ophthalmol 1976;82(6):905–9.PubMedGoogle Scholar
  58. 58.
    Ahmad SM, Esmaeli B, Williams M, et al. American Joint Committee on Cancer classification predicts outcome of patients with lacrimal-gland adenoid cystic carcinoma. Ophthalmology 2009;116(6):1210–15.PubMedCrossRefGoogle Scholar
  59. 59.
    Eviatar JA, Hornblass A. Mucoepidermoid carcinoma of the lacrimal gland: 25 cases and a review and update of the literature [review]. Ophthal Plast Reconstr Surg 1993;9(3):170–81.PubMedCrossRefGoogle Scholar
  60. 60.
    Dithmar S, Wojno TH, Washington C, et al. Mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion. Ophthal Plast Reconstr Surg 2000;16(2):162–6.PubMedCrossRefGoogle Scholar
  61. 61.
    Henderson JW, Farrow GM. Primary malignant mixed tumors of the lacrimal gland. Report of 10 cases. Ophthalmology 1980;87(6):466–75.PubMedGoogle Scholar
  62. 62.
    De Rosa G, Zeppa P, Tranfa F, et al. Acinic cell carcinoma arising in a lacrimal gland. First case report. Cancer 1986;57(10):1988–91.PubMedCrossRefGoogle Scholar
  63. 63.
    Ni C, Ma X. Primary epithelial lacrimal gland tumors: the pathologic classification of 272 cases. Yan Ke Xue Bao 1994;10(4):201–5.PubMedGoogle Scholar
  64. 64.
    Ostrowski ML, Font RL, Halpern J, et al. Clear cell epithelial–myoepithelial carcinoma arising in pleomorphic adenoma of the lacrimal gland. Ophthalmology 1994;101(5):925–30.PubMedGoogle Scholar
  65. 65.
    Font RL, Patipa M, Rosenbaum PS, et al. Correlation of computed tomographic and histopathologic features in malignant transformation of benign mixed tumor of the lacrimal gland. Surv Ophthalmol 1990;34(6):449–52.PubMedCrossRefGoogle Scholar
  66. 66.
    Heaps RS, Miller NR, Albert DM, et al. Primary adenocarcinoma of the lacrimal gland. A retrospective study. Ophthalmology 1993;100(12):1856–60.PubMedGoogle Scholar
  67. 67.
    Shields JA, Shields CL, Epstein JA, et al. Primary epithelial malignancies of the lacrimal gland: the 2003 Ramon L. Font lecture. Ophthal Plast Reconstr Surg 2004;20:10–21.PubMedCrossRefGoogle Scholar
  68. 68.
    Katz SE, Rootman J, Dolman PJ, et al. Primary ductal adenocarcinoma of the lacrimal gland. Ophthalmology 1996;103:157–62.PubMedGoogle Scholar
  69. 69.
    Nasu M, Haisa T, Kondo T, et al. Primary ductal adenocarcinoma of the lacrimal gland. Pathol Int 1998;48:981–4.PubMedCrossRefGoogle Scholar
  70. 70.
    Krishnakumar S, Subramanian N, Mahesh L, et al. Primary ductal adenocarcinoma of the lacrimal gland in a patient with neurofibromatosis [letter]. Eye 2003;17:843–5.PubMedCrossRefGoogle Scholar
  71. 71.
    Milman T, Shields JA, Husson M, et al. Primary ductal adenocarcinoma of the lacrimal gland. Ophthalmology 2005;12(11):2048–51.CrossRefGoogle Scholar
  72. 72.
    Su GW, Patipa M, Font RL. Primary squamous cell carcinoma arising from an epithelium-lined cyst of the lacrimal gland. Ophthal Plast Reconstr Surg 2005;21(5):383–5.PubMedCrossRefGoogle Scholar
  73. 73.
    Hotta K, Arisawa T, Mito H, et al. Primary squamous cell carcinoma of the lacrimal gland. Clin Exp Ophthalmol 2005;33(5):534–6.CrossRefGoogle Scholar
  74. 74.
    Patel SG, Shah JP. TNM Staging of cancers of the head and neck: striving for uniformity among diversity. CA Cancer J Clin 2005;55:242–5.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Section of Oculoplastics, Orbital and Cosmetic Surgery, Department of OphthalmologyEmory University Eye CenterAtlantaUSA
  2. 2.Section of Ophthalmology, Department of Head and Neck SurgeryThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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