CT AND MRI RELIABILITY IN THE DIAGNOSIS OF LACRIMAL FOSSA TUMORS

This prospective study sought to verify whether computed tomography (C T) and magnetic resonance imaging (MRI) can be used as reliable means for planning a therapeutic approach to lacrimal fossa tumors. Twenty-s ix cases of lacrimal of a gland mass at first observation were studied . After clinical and radiologic evaluation, the most likely diagnosis was recorded for each patient before treatment. The conclusive diagnos is was based on a histologic examination or (only in case of acute pse udotumor) on a prompt and complete response to steroids. All lymphomas (seven cases) and pseudotumors (four cases) were correctly identified . Two cases of benign lymphoid hyperplasia were suspected to be pseudo tumors. All epithelial tumors (six cases) were recognized, except for a pseudocystic necrotic carcinoma, which was suspected to be a dermoid . All dermoids (five cases) were identified. An intraosseous hemangiom a was suspected to be an aneurysmal bone cyst, and a cholesterol granu loma was suspected to be a dermoid. CT and MRI, combined with clinical recognition of inflammatory signs, can provide sufficient information to guide the therapeutic approach to lacrimal fossa tumors. Identific ation of rare tumors and the differentiation of carcinomas from adenom as may result. General guidelines for treatment include: Excisional bi opsy for rounded tumors with smooth margins (including cystic lesions) A steroid trial for recent wedge-shaped tumors Incisional biopsy for longstanding or steroid-resistant wedge-shaped tumors.