Technique for incisional biopsy of a lacrimal gland mass when the diagnosis of benign mixed tumor cannot be excluded clinically.

In most cases of a lacrimal gland mass, the management course can be defined clearly based on an accurate history supported by characteristic radiographic features. There are, however, certain cases that do not fit cleanly into management algorithms and, on occasion, it may be necessary to obtain an incisional biopsy into a lacrimal gland mass when the diagnosis of benign mixed tumor cannot be excluded conclusively. We report a technique for incisional lacrimal gland biopsy under these circumstances. To prevent tumor spillage in the event of benign mixed tumor, the incision site into the gland is covered with several drops of butyl-2-cyanoacrylate. The biopsy specimen is submitted for frozen section examination. If the frozen section reveals benign mixed tumor, the entire gland may be removed, with the cyanoacrylate bond protecting the lacrimal gland contents from contaminating the orbit. The technique and its indications are described in detail.