En bloc removal of intrinsic neoplasms of the lacrimal gland.

The management of intrinsic neoplasms primary in the lacrimal gland is of serious concern because (1) some of the most malignant primary tumors of the orbit occur in this glandular structure and (2) present surgical techniques may easily disseminate the neoplasm and contribute to death or recurrences. We propose a surgical approach in which the tumor and adjacent adnexa are removed in a one-stage procedure, that is, an en bloc resection of the neoplasm, its periorbital base, and surrounding bone. This technique will minimize seeding of the tumor, provide a more complete eradication of the neoplasm without loss of the eye, and hopefully, assure either a cure or a longer interval free of local recurrences or metastasis than is presently attainable.