Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Ophthalmology. 2011 Oct;118(10):2088-92. doi: 10.1016/j.ophtha.2011.03.014.
To report the clinical and computed tomography (CT) features of recurrent lacrimal gland pleomorphic adenoma (LGPA).
Retrospective observational case series.
Five patients with recurrent LGPA.
Clinical records and CT findings in 5 patients with recurrent LGPA were reviewed.
Clinical and CT features, malignant transformation, and disease-free survival.
Five patients presented at intervals of 9 to 19 years after initial surgery for LGPA with symptoms and signs of recurrent tumor centered on the lacrimal gland fossa. Four patients underwent surgery to remove recurrent tumor, and 1 patient declined surgical intervention. One of the 4 operated patients was found to have malignant transformation and required craniofacial resection for tumor clearance. One patient had benign recurrence in a previously exenterated orbit and also required a craniofacial resection. Two patients with benign but multifocal recurrence had en bloc resection of tumor, but remain at risk of further recurrence. Computed tomography in all 5 patients revealed irregular bone erosion and remodeling in relation to nodules of recurrent tumor, despite only 1 of these patients having confirmed malignant transformation. Four patients were free of disease at their last follow-up at intervals of 9 months to 18 years, including the patient with malignant transformation (14 years follow-up). One patient who declined treatment has been lost to follow-up.
Recurrent LGPA tends to develop multifocally and may be widespread in the operative field. Computed tomography shows recurrent tumor nodules that are often associated with irregular bony erosion and remodeling despite these recurrences being usually benign. Repeated recurrence requiring further surgery with potential significant morbidity remains a lifelong risk, and malignant transformation in recurrent LGPA may also occur.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
报告复发性泪腺多形性腺瘤（LGPA）的临床和计算机断层扫描（CT）特征。
回顾性观察性病例系列。
5 例复发性 LGPA 患者。
回顾了 5 例复发性 LGPA 患者的临床记录和 CT 发现。
临床和 CT 特征、恶性转化和无病生存。
5 例患者在初次手术治疗 LGPA 后 9 至 19 年出现症状和体征，提示泪腺窝内复发性肿瘤。4 例患者接受手术切除复发性肿瘤，1 例患者拒绝手术干预。4 例手术患者中有 1 例发现恶性转化，需要行颅面切除术清除肿瘤。1 例患者在先前行眶内容切除术的眼眶内良性复发，也需要行颅面切除术。2 例有良性但多灶性复发的患者行肿瘤整块切除术，但仍有复发的风险。所有 5 例患者的 CT 均显示与复发性肿瘤结节相关的不规则骨侵蚀和重塑，尽管其中只有 1 例患者有明确的恶性转化。4 例患者在最后一次随访时无疾病，随访时间为 9 个月至 18 年，包括 1 例恶性转化患者（随访 14 年）。1 例拒绝治疗的患者失访。
复发性 LGPA 往往多灶性发生，并可能在手术部位广泛扩散。CT 显示复发性肿瘤结节，这些结节常与不规则骨侵蚀和重塑相关，尽管这些复发通常是良性的。需要反复手术切除，可能会导致严重的发病率，复发性 LGPA 也可能发生恶性转化。
作者在本文讨论的材料中没有任何专有或商业利益。
