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Pleomorphic adenoma of the lacrimal gland
Medical expert of the article
Last reviewed: 07.07.2025
[ Symptoms of lacrimal gland adenoma
It appears in the 5th decade of life as a painless, slowly increasing swelling in the upper outer region of the orbit and usually lasts more than a year.
- The tumor, arising from the orbital lobe, is a smooth, firm, painless mass in the lacrimal gland fossa, displacing the eyeball in an inferior nasal direction.
- Posterior growth may cause exophthalmos, ophthalmoplegia, and choroidal folds.
Less often, the tumor develops from the palpebral lobe and tends to grow in an anterior direction, is accompanied by an increase in the upper eyelid and does not lead to displacement of the eyeball.
CT reveals a round or oval formation with a smooth contour with expansion, but without destruction of the bone in the area of the lacrimal gland fossa. The formation may also compress the eyeball.
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Treatment of lacrimal gland adenoma
Treatment consists of surgical removal. It is recommended to avoid biopsy in order to prevent dissemination of the tumor into the surrounding orbital tissue, although this is not always possible due to diagnostic uncertainty. Palpebral lobe tumors are usually excised within healthy tissue using anterior (transfascial) orbitotomy. For orbital lobe tumors, lateral orbitotomy is performed:
- dissect the temporal muscle;
- the underlying bone is drilled for subsequent placement of wire sutures;
- the outer wall of the orbit and the tumor are removed;
- restore the temporal muscle and periosteum.
The prognosis is quite favorable with complete removal and provided that tissue rupture is prevented. Incomplete removal or preliminary biopsy contribute to the dissemination of tumor cells into surrounding tissues, relapse with possible malignancy.