Font R L, Smith S L, Bryan R G
Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Tex 77030, USA.
Arch Ophthalmol. 1998 May;116(5):613-6. doi: 10.1001/archopht.116.5.613.
To analyze 120 lacrimal gland masses collected during a 23-year period in the Ophthalmic Pathology Laboratory at the Cullen Eye Institute, Houston, Tex.
Of the 120 lacrimal gland tumors, we focused on a detailed clinicopathologic study of 21 malignant epithelial tumors. Follow-up was available in 19 (90%) of 21 cases.
About two thirds of the masses (75 cases) were inflammatory, one third (41 cases) were of epithelial origin, and 3% (4 cases) were malignant lymphomas. Of the epithelial tumors, 17 (41%) were benign mixed tumors, 12 (29%) were adenoid cystic carcinomas arising de novo, 2 (5%) were adenocarcinoma arising de novo, 7 (17%) were malignant mixed tumors, and 3 (7%) were metastatic carcinoma. All of the patients with adenoid cystic carcinoma had local recurrences, and 60% of the patients died of their tumors (mean survival, 5 years); only 2 patients were alive 13 and 16 years after the initial surgery, both of whom had radical surgical procedures for recurrence following orbital exenteration.
The histopathologic classification and management of these tumors are discussed. This study supports the dismal prognosis of adenoid cystic carcinoma arising de novo.
分析得克萨斯州休斯顿市卡伦眼科研究所眼科病理实验室在23年期间收集的120例泪腺肿物。
在这120例泪腺肿瘤中，我们重点对21例恶性上皮性肿瘤进行了详细的临床病理研究。21例中有19例（90%）获得了随访。
约三分之二的肿物（75例）为炎性，三分之一（41例）为上皮源性，3%（4例）为恶性淋巴瘤。在上皮性肿瘤中，17例（41%）为良性混合瘤，12例（29%）为原发性腺样囊性癌，2例（5%）为原发性腺癌，7例（17%）为恶性混合瘤，3例（7%）为转移性癌。所有腺样囊性癌患者均出现局部复发，60%的患者死于肿瘤（平均生存期5年）；仅2例患者在初次手术后13年和16年仍存活，二者均因复发行眼眶内容剜除术后接受了根治性手术。
讨论了这些肿瘤的组织病理学分类及处理方法。本研究支持原发性腺样囊性癌预后不良的观点。
