Auran J, Jakobiec F A, Krebs W
Department of Ophthalmology, Manhattan Eye, Ear & Throat Hospital, New York, NY 10021.
Ophthalmology. 1988 Jan;95(1):90-9. doi: 10.1016/s0161-6420(88)33223-9.
The treatment of suspected benign mixed tumor (pleomorphic adenoma) of the lacrimal gland consists of wide local surgical excision of the tumor and its capsule in their entirety. The tumor should be approached routinely via a lateral orbitotomy to provide maximal exposure and allow complete removal of the lesion. However, if clinical and radiographic evidence indicates a far anterior location implying an origin in the more superficial palpebral lobe, an anterior transcutaneous approach is advantageous and preferred. The authors report an adult case of an anteriorly located benign mixed tumor of the palpebral lobe of the lacrimal gland. The authors reviewed the characteristic clinical, echographic, and computed tomographic (CT) features, offered a differential diagnosis, and described surgical removal using a cryoprobe via an anterior lid approach. An awareness of the distinctive clinical and diagnostic features of benign mixed tumor of the palpebral lobe should help to avoid the complications that ensue from an incisional biopsy or piecemeal resection through the lid, and also to avoid the need for more extensive surgery for removal of residual or recurrent tumor.
泪腺可疑良性混合瘤(多形性腺瘤)的治疗包括对肿瘤及其包膜进行广泛的局部手术切除。通常应通过外侧眶切开术来处理肿瘤,以获得最大程度的暴露并确保完全切除病变。然而,如果临床和影像学证据表明肿瘤位置靠前,提示起源于更浅表的睑叶,则经皮前路手术具有优势且更为可取。作者报告了1例成人泪腺睑叶前部良性混合瘤病例。作者回顾了其特征性的临床、超声和计算机断层扫描(CT)表现,进行了鉴别诊断,并描述了通过前睑入路使用冷冻探头进行手术切除的过程。了解泪腺睑叶良性混合瘤独特的临床和诊断特征,有助于避免因经睑切开活检或部分切除而导致的并发症,也可避免为切除残留或复发性肿瘤而进行更广泛手术的必要性。