Department of Ophthalmology, National University Hospital, Singapore.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Br J Ophthalmol. 2019 Feb;103(2):264-268. doi: 10.1136/bjophthalmol-2017-311538. Epub 2018 Apr 21.
To investigate the clinical and imaging features of primary and recurrent lacrimal gland pleomorphic adenoma (LGPA), as well as lacrimal gland malignant epithelial tumours (LGMET).
Retrospective comparative case series from September 2000 to September 2016 in a single tertiary institution. Medical records of cases with histopathologically proven primary LGPA (PLGPA), recurrent LGPA (RLGPA) and LGMET were reviewed.
Sixty-four patients with LGPA (55 primary and nine recurrent) and 36 patients with LGMET underwent surgical excision in the study period. There was no significant difference in terms of age, gender or laterality. In terms of symptom duration, that of LGMET (7.1 months) was significantly shorter than PLGPA (23.9 months), which in turn was significantly shorter than RLGPA (127.1 months). Proptosis was the most common presenting symptom among all three groups. On CT, LGMET and RLGPA were significantly more likely to have ill-defined margins (p<0.001) and be heterogeneous (p<0.001) than PLGPA. RLGPAs (56%) were significantly more likely to have calcification than LGMET (34%), which in turn was more likely to have calcification than PLGPA (13%); LGMET (40%) and RLGPA (33%) were significantly more likely to have bony invasion than PLGPA (2.2%). On MRI, LGMETs (55%) were significantly more likely to have a tail or wedge sign indicating infiltration into the posterior orbit than PLGPA (0%) or RLGPA (0%).
Our study adds important information regarding differentiating clinical and radiological features between malignant and benign epithelial lacrimal gland tumours that would aid in their management.
探讨原发性和复发性泪腺多形性腺瘤（LGPA）以及泪腺恶性上皮肿瘤（LGMET）的临床和影像学特征。
这是一项在 2000 年 9 月至 2016 年 9 月于一家三级医疗机构进行的回顾性对比病例系列研究。对经组织病理学证实为原发性 LGPA（PLGPA）、复发性 LGPA（RLGPA）和 LGMET 的病例的病历进行了回顾性分析。
在研究期间，共有 64 例 LGPA（55 例原发性，9 例复发性）和 36 例 LGMET 患者接受了手术切除。三组患者的年龄、性别或侧别均无显著差异。在症状持续时间方面，LGMET（7.1 个月）明显短于 PLGPA（23.9 个月），而 PLGPA 又明显短于 RLGPA（127.1 个月）。突眼是三组患者最常见的首发症状。在 CT 上，LGMET 和 RLGPA 比 PLGPA 更有可能表现为边界不清（p<0.001）和不均匀（p<0.001）。RLGPA（56%）比 LGMET（34%）更易发生钙化，而 LGMET 又比 PLGPA（13%）更易发生钙化；LGMET（40%）和 RLGPA（33%）比 PLGPA（2.2%）更易发生骨质侵犯。在 MRI 上，LGMET（55%）比 PLGPA（0%）或 RLGPA（0%）更易出现提示向后眶浸润的“尾巴”或“楔形”征。
本研究提供了有关区分良恶性上皮性泪腺肿瘤的临床和影像学特征的重要信息，有助于其治疗。
