Pleomorphic adenoma of the lacrimal glands
Citation, DOI, disclosures and article data
At the time the article was created Neil Lall had no recorded disclosures.View Neil Lall's current disclosures
At the time the article was last revised Daniel J Bell had no recorded disclosures.View Daniel J Bell's current disclosures
Pleomorphic adenomas of the lacrimal glands, also known as benign mixed tumors (BMTs), are the most common lacrimal gland tumors.
On this page:
Historically pleomorphic adenomas have also been called benign mixed tumors, however this name is now discouraged. It was previously thought that these were a form of teratoma, however it is now clear that the neoplasm forms from a single layer of germ cells and is purely epithelial in nature 4.
- 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
- 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
- round or oval in shape
- occasional punctate calcifications
- bony remodeling of the lacrimal fossa
- moderate to marked contrast enhancement
- 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.
- other lacrimal gland masses
- extralacrimal masses of the superolateral orbit such as dermoid/epidermoid cyst
- 1. R. Vaidhyanath, R. Kirke, L. Brown, R. Sampath. Lacrimal Fossa Lesions: Pictorial Review of CT and MRI Features. (2009) Orbit. 27 (6): 410-8. doi:10.1080/01676830802333667 - Pubmed
- 2. Karcioğlu ZA. Orbital tumors, diagnosis and treatment. Springer Verlag. (2005) ISBN:038721321X. Read it at Google Books - Find it at Amazon
- 3. Jung WS, Ahn KJ, Park MR, Kim JY, Choi JJ, Kim BS, Hahn ST. The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa. (2007) Korean journal of radiology. 8 (4): 336-42. doi:10.3348/kjr.2007.8.4.336 - Pubmed
- 4. The recurrent pleomorphic adenoma conundrum. (2018) Current Opinion in Otolaryngology & Head and Neck Surgery. 26 (2): 134. doi:10.1097/MOO.0000000000000435 - Pubmed