Introduction
Can either be epithelial or non-epithelial, and can also be either benign or malignant.
- Epithelial: 40-55% of all lacrimal masses; 55% benign mixed; 50% malignant
- Malignant epithelial tumours: accounts for 2% of all orbital tumours.
- Most common epithelial orbital cancer = adenoid cystic carcinoma.
Dead Giveaways
Benign:
Pleomorphic --> mainly orbital lobe and rarely palpebral. Combined epithelial and mesenchymal cells
55% epithelial lacrimal gland tumours are benign mixed tumours
Commonly seen in 2nd to 5th decade (mean ~39y)
M>F by 1.5x
Malignant:
Adenoid Cystic Carcinoma --> rare but most common lacrimal
Symptomatic duration is short <6 - 12 months
Around 4th decade
diagnostic features
Pleomorphic Tumour Symptoms:
Painless exophthalmos, axial downward globe displacement, diplopia, retinal striations, fullness of upper eyelids and palpable eyelid mass
Slowly progressive over 12 or more months.
Adenoid Cystic Carcinoma:
Exophthalmos
Downward globe
Displacement
Ptosis
Diplopia
Orbital pain due to perineural tumour (common)
Rapid onset with poor prognosis and causes contiguous erosion of bone
High morbidity and mortality
Referral for CT scan and biopsy.
Treatment of Adenoid Cystic Carcinoma:
excision with adjacent tissue