Diagnosis, imaging findings, and surgical treatment of benign lacrimal gland tumors, pleomorphic adenomas

👁 Pleomorphic Adenoma – The Most Common Benign Lacrimal Gland Tumor

Lacrimal gland tumors are rare orbital lesions, accounting for only 10% of orbital masses.
Among them, pleomorphic adenoma is the most frequent benign epithelial tumor arising directly from the lacrimal gland.

It typically occurs in adults in their 40s to 50s, with equal gender distribution, and tends to grow slowly and painlessly.

 

 

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✅ Clinical Features

• Painless and slow-growing orbital mass
• Located in the superotemporal orbit
• May cause inferomedial displacement of the globe
• Proptosis may be present in larger masses
• Usually develops over months to a year

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✅ Radiologic Findings (CT/MRI)

• Well-defined, round or oval mass
• Indents the globe without infiltrating it
• May cause smooth bony erosion of the lacrimal fossa
• MRI may incidentally detect the tumor during unrelated evaluation

The well-circumscribed nature is due to a pseudocapsule surrounding the mass –
a hallmark of benign behavior.

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✅ Diagnosis and Treatment

• Diagnosis can be made without biopsy due to classic radiologic appearance
• Biopsy is discouraged to prevent pseudocapsule disruption
• Treatment is complete surgical excision via lateral orbitotomy
• If pseudocapsule is violated, there's up to 30% recurrence
  and ~20% chance of malignant transformation over decades

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✅ Summary Table

FeatureDescription

Location	Superotemporal orbit (lacrimal gland fossa)
Symptoms	Painless mass, globe displacement
Imaging	Well-circumscribed, non-invasive
Treatment	Complete excision without capsular rupture
Risks	Recurrence if incomplete removal; malignant transformation possible