TUMORS ARISING IN THE PALPEBRAL LOBE OF THE LACRIMAL GLAND

Purpose: Tumors arising in the palpebral lobe of the lacrimal gland ar e uncommon, There have been only eight reported patients, all of whom had pleomorphic adenomas. The authors present another six patients wit h primary palpebral robe tumors. Methods: The clinical presentation, c omputed tomographic, and pathologic findings of these six patients wer e reviewed. Results: Tumor types include three pleomorphic adenomas, o ne well-differentiated adenoid cystic carcinoma, one carcinoma in pleo morphic adenoma, and one carcinoma ex pleomorphic adenoma. All six pat ients presented with a painless mass in the upper outer eyelid without significant displacement of the globe, but the superficial location o f these lesions led to early detection. The tumors were localized to t he lacrimal gland, predominantly anterior to the orbital rim, In all s ix patients, the involved palpebral lobe was removed, five via a direc t anterior subcutaneous approach and one by superolateral orbitotomy. In two patients (adenoid cystic carcinoma and carcinoma ex pleomorphic adenoma), repeat surgery via superolateral orbitotomy was necessary t o achieve complete removal of the lacrimal gland and surrounding tissu e. No recurrences were detected during follow-up (range, 6 months to 7 years; mean, 26 months). Conclusion: Palpebral lobe tumors of the lac rimal gland are more common and consist of a greater variety of histol ogic types than previously described, In our series, these tumors comp rise 17% of all epithelial lacrimal gland lesions, These are the first reported cases of malignancy in this location. A longer follow-up per iod is necessary to determine the true recurrence rate of these tumors .