Wilson Kevin F, Ward P Daniel, Spector Matthew E, Marentette Lawrence J
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Ann Otol Rhinol Laryngol. 2011 Jun;120(6):397-400. doi: 10.1177/000348941112000609.
Multiple treatment options exist for management of adenoid cystic carcinoma of the lacrimal gland. Our objective was to perform an analysis of outcomes in a cohort of patients with adenoid cystic carcinoma of the lacrimal gland treated identically with an orbitocranial approach.
We performed a retrospective review of 7 consecutive patients who presented to a tertiary care academic medical center between 1995 and 2009 with adenoid cystic carcinoma of the lacrimal gland.
All patients were treated with an orbitocranial approach to tumor resection followed by postoperative radiotherapy. The mean and median follow-up times were 39 and 19 months, respectively (range, 7 to 138 months). Six patients had orbital reconstruction using free tissue transfer, and 1 patient had a split-thickness skin graft to line the orbital cavity. Two patients developed distant metastases 18 months and 29 months after surgery and ultimately died with disease. Five patients are alive without disease.
The orbitocranial approach followed by postoperative irradiation achieves excellent local and regional control rates for adenoid cystic carcinoma of the lacrimal gland, although patients remain at risk long-term for distant metastases. Orbital bone removal to obtain adequate margins should be a routine part of tumor resection for these malignancies.
泪腺腺样囊性癌的治疗有多种选择。我们的目的是对一组采用眶颅入路进行相同治疗的泪腺腺样囊性癌患者的治疗结果进行分析。
我们对1995年至2009年间在一家三级医疗学术中心就诊的7例泪腺腺样囊性癌患者进行了回顾性研究。
所有患者均采用眶颅入路进行肿瘤切除，术后进行放疗。平均随访时间和中位随访时间分别为39个月和19个月（范围7至138个月）。6例患者采用游离组织移植进行眼眶重建，1例患者采用中厚皮片移植来衬里眼眶腔。2例患者在术后18个月和29个月发生远处转移，最终死于该疾病。5例患者存活且无疾病。
眶颅入路联合术后放疗可实现泪腺腺样囊性癌良好的局部和区域控制率，尽管患者长期仍有发生远处转移的风险。为获得足够的切缘而进行眼眶骨切除应成为这些恶性肿瘤肿瘤切除的常规部分。
