Fasina Oluyemi, Adeoye Adewunmi Oluseye, Aremu Olanipekun Olalekan
Department of Ophthalmology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Department of Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
J West Afr Coll Surg. 2020 Apr-Jun;10(2):5-11. doi: 10.4103/jwas.jwas_33_21. Epub 2022 Mar 26.
Epithelial lacrimal gland tumours are uncommon orbital tumours and are not widely reported among African populations.
This study aimed to describe the clinicopathological features, treatment, and outcomes of epithelial lacrimal gland tumours in Nigeria.
Retrospective case series.
Ocular Oncology Unit, Ophthalmology Department and Pathology Department of University College Hospital, Ibadan, Nigeria.
A review of the medical records of all patients with histopathological diagnoses of epithelial lacrimal gland tumours managed at a tertiary health facility, southwestern Nigeria over 11.5 years was carried out.
Eighteen patients with equal numbers of men and women, and mean age at presentation of 42.2 ± 15.7 years (median 42 years, range 17-70 years) were managed. All patients presented with orbital swelling and had nonaxial proptosis with palpable firm to hard mass in the superotemporal quadrant of the orbit. The mean duration of symptoms was 42.2 ± 38.6 months (median 24 months, range 3-120 months). Visual acuity was <3/60 at presentation in eight (44.4%) of the affected eyes. Thirteen (72.2%) patients underwent orbitotomy and tumour excision, while five (27.8%) patients had orbital exenteration, and two of whom (11.1%) had combined orbital exenteration and craniotomy. Histopathological examination of the specimens revealed pleomorphic adenoma in nine (50.0%) patients, low-grade mucoepidermoid carcinoma in three (16.7%) patients, high-grade mucoepidermoid carcinoma in two (11.1%) patients, adenoid cystic carcinoma in three (16.7%) patients, and adenocarcinoma "not otherwise specified" in one (5.6%) patient. Mortality was reported in four (44.4%) of nine patients with malignant tumours, while no mortality was noted in the patients with benign pleomorphic adenoma. The mean follow-up period for the patients was 28.9 months (median, 4.5 months; range, 2-140 months).
The main presenting symptom of epithelial lacrimal gland tumours in our patients was an orbital mass and the most common clinical finding, in addition to the orbital mass, was nonaxial proptosis. The tumours were equally divided into benign and malignant lesions in our studied population. Pleomorphic adenoma was the only benign tumour while mucoepidermoid carcinoma was the commonest malignant lesion. Orbital exenteration was performed in a high proportion of our patients and high mortality was noted among patients with malignant tumours.
上皮性泪腺肿瘤是罕见的眼眶肿瘤，在非洲人群中的报道并不广泛。
本研究旨在描述尼日利亚上皮性泪腺肿瘤的临床病理特征、治疗方法及预后。
回顾性病例系列研究。
尼日利亚伊巴丹大学学院医院眼科的眼肿瘤科以及病理科。
对尼日利亚西南部一家三级医疗机构11.5年间收治的所有经组织病理学诊断为上皮性泪腺肿瘤患者的病历进行回顾性分析。
共诊治18例患者，男女各9例，就诊时平均年龄为42.2±15.7岁（中位数42岁，范围17 - 70岁）。所有患者均表现为眼眶肿物，且为非轴性眼球突出，在眼眶颞上象限可触及质地硬韧至坚硬的肿块。症状平均持续时间为42.2±38.6个月（中位数24个月，范围3 - 120个月）。8只患眼（44.4%）就诊时视力<3/60。13例（72.2%）患者接受了眼眶切开术及肿瘤切除术，5例（27.8%）患者行眼眶内容剜除术，其中2例（11.1%）同时行眼眶内容剜除术及开颅手术。标本的组织病理学检查显示，9例（50.0%）为多形性腺瘤，3例（16.7%）为低级别黏液表皮样癌，2例（11.1%）为高级别黏液表皮样癌，3例（16.7%）为腺样囊性癌，1例（5.6%）为“未另行规定”的腺癌。9例恶性肿瘤患者中有4例（44.4%）死亡，而良性多形性腺瘤患者无死亡病例。患者的平均随访期为28.9个月（中位数4.5个月，范围2 - 140个月）。
我们研究的患者中，上皮性泪腺肿瘤的主要表现症状为眼眶肿物，除眼眶肿物外最常见的临床体征为非轴性眼球突出。在我们的研究人群中，肿瘤分为良性和恶性病变，数量相当。多形性腺瘤是唯一的良性肿瘤，而黏液表皮样癌是最常见的恶性病变。我们的患者中很大一部分接受了眼眶内容剜除术，恶性肿瘤患者的死亡率较高。
