Surgical management of malignant tumors of the lacrimal gland.

Malignant lacrimal gland tumors are rare but serious and life-threatening neoplasms. Patients frequently present with symptoms of less than 1 year duration, often demonstrating rapid change during the 6 months preceding diagnosis. Pain and periorbital sensory changes are also reported by patients. Radiographically, bone destruction is a strong indication of a lacrimal gland malignancy as is ophthalmoplegia. Radical three-dimensional resection utilizing a cranioorbital approach offers the best chance for total tumor removal. Immediate reconstruction with a scalp flap is essential for primary healing, as well as esthetic balance of the orbital region.