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Oral Maxillofac Surg (2015) 19:433436 DOI 10.1007/s10006-015-0514-5
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Web End = CASE REPORT
Orbital lobe resection provides a definite diagnosis of lacrimal gland lesions: a report of three cases
Christina Schnabl1 & Christian Khn1 & Jan Rustemeyer1
Received: 27 March 2015 /Accepted: 9 June 2015 /Published online: 23 June 2015 # Springer-Verlag Berlin Heidelberg 2015
AbstractBackground Entities of lacrimal gland lesions comprise almost inflammatory and lymphoproliferative processes as well as benign and malignant solid tumors and usually cannot be differentiated by magnetic resonance imaging (MRI) exclusively. Hence, representative tissue samples are needed to arrive at sufficient histopathological diagnosis for further treatment decisions.
Case report Three women aged between 18 and 67 years were admitted to our center with clinical signs of a space-occupying mass in the lacrimal fossa. MRI revealed a circumscribed lacrimal gland lesion in all three cases. The orbital lobe was resected through a lateral orbitotomy approach for histopathological evaluation. Findings confirmed the diagnoses of pleomorphic adenoma, dacryoadenitis, and low-grade B cell non-Hodgkins lymphoma. Further surgery was not necessary. No recurrence or symptoms of Bdry eye^ were observed over the course of a 1-year follow-up.
Conclusion In cases of non-specific masses in the lacrimal gland on MRI, histopathological diagnoses are vital and can be sufficiently provided by resection of the orbital lobe. Symptoms of dry eye are uncommon, and secondary surgical intervention can be avoided in cases of the presented entities. Further studies with larger patient cohorts are warranted to confirm these findings.
Keywords Lacrimal gland . Orbital lobe . Dry eye . Orbitotomy . MRI . Dacryoadenitis
Introduction
Lesions of the lacrimal gland cover a large spectrum of masses with similarities in clinical signs and symptoms, but having diverse biological behaviors and prognoses. Chronic dacryoadenitis was found to be the most common histopathological diagnosis of lacrimal gland lesions (46 %), followed by lymphoproliferative disorders (38 %) and pleomorphic adenoma (10 %) [1]. In contrast, malignant tumors or metastases of the lacrimal gland are comparatively rare. Female predominance is common among all lacrimal gland lesions [24]. Currently, magnetic resonance imaging (MRI) is the preferred...