Pleomorphic adenoma of the lacrimal glands
Updates to Article Attributes
Body
was changed:
Pleomorphic adenomas of the lacrimal glands,also known as benign mixed tumors (BMTs), are the most common lacrimal gland tumors.
Clinical presentation
- slowly progressive and painless proptosis, with inferomedial displacement of the globe
- visual disturbance possible with large tumors
- sudden onset of pain may indicate malignant transformation
Radiographic features
CT
- solid or heterogeneous
- highly cellular and smaller tumors are more homogeneous
- less cellular and larger tumors may be more heterogeneous from mesenchymal stroma, cystic degeneration, necrosis, or serous/mucous collection
- well
circumscribed-circumscribed - round or oval in shape
- occasional punctate calcifications
- bony
remodelingremodelling of the lacrimal fossa - moderate to marked contrast enhancement
MRI
- T1: iso- to hypointense to muscle
- T2: iso- to hyperintense to muscle
- T1 C+: moderate to marked enhancement
- heterogeneity may vary with size/cellularity as with CT
Treatment and prognosis
Complete excision is curative, with an excellent prognosis. Incomplete excision is associated with high rates of recurrence.
Risk of malignant transformation is low but cumulative over time.
Differential diagnosis
- other lacrimal gland masses
- extralacrimal masses of the superolateral orbit such as dermoid
/epidermoid/epidermoid cyst
-<li>well circumscribed</li>- +<li>well-circumscribed</li>
-<li>bony remodeling of lacrimal fossa</li>- +<li>bony remodelling of the lacrimal fossa</li>
-<li>extralacrimal masses of the superolateral orbit such as <a href="/articles/orbital-dermoid-cyst">dermoid</a>/epidermoid cyst</li>- +<li>extralacrimal masses of the superolateral orbit such as <a href="/articles/orbital-dermoid-cyst">dermoid</a>/<a title="Orbital epidermoid cyst" href="/articles/orbital-epidermoid-cyst">epidermoid cyst</a>
- +</li>
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