Epithelial Lacrimal Gland Tumors

Abstract

To apply the updated epithelial salivary gland classification scheme to a large cohort of lacrimal gland tumors so as to provide an updated lacrimal gland tumor classification scheme. Methods: A retrospective multicenter cohort study of 118 cases of epithelial neoplasia was undertaken. Main outcome measures included pathologic analysis, subtyping, and survival. Results: Of 118 cases, 17 (14%) were reclassified using the proposed expanded classification scheme based on the current World Health Organization classification of salivary gland tumors. The most frequent neoplasms were pleomorphic adenoma and adenoid cystic carcinoma, of which we highlight more unusual histologic features. Three tumors were found to be unclassifiable with the updated scheme, with 2 having histologically malignant features. Deficiencies and variations in pathologic assessment were noted. Variation in the histologic findings of pleomorphic adenoma and assessment of the extent of invasion of carcinoma ex pleomorphic adenoma were highlighted. Conclusions: The use of the more histologically diverse classification of salivary gland tumors can be successfully applied to the epithelial lacrimal gland neoplasms. This expanded classification system led to reclassifying 14% of cases. Currently, there are no consistent pathologic standards for processing and evaluating these lesions.

Mucoepidermoid carcinoma ex pleomorphic adenoma of the lacrimal gland: A rare presentation

“…Of the nine cases of the latter, the malignant components included seven adenocarcinomas, one carcinosarcoma and one mucoepidermoid carcinoma. [5]…”

“…The scoring system is based on five histologic features namely intracystic component, neural invasion, necrosis, mitotic activity and anaplasia[34] CEPA is sub-classified into non-invasive carcinoma or carcinoma in situ , minimally invasive (<1.5 mm of invasion from the capsule) and invasive carcinoma (>1.5 mm of invasion from the capsule). [125] Computed tomography (CT) of the orbit may demonstrate features of both benign mixed tumor and invasive carcinoma. Bone erosion and calcification should raise the index of suspicion of malignancy in lacrimal gland tumors.…”

Adenocarcinoma, Not Otherwise Specified, Arising in Accessory Lacrimal Gland: A Diagnostic Challenge

“…The rarity of these lesions necessitates adoption of the continually evolving and diversifying classification scheme for the salivary gland tumors. This successful application of salivary gland classification to the lacrimal gland neoplasms is reflected in a decline in frequency of primary lacrimal gland adenocarcinoma from 10% of all malignant lacrimal gland tumors in a 2003 review by Shields et al [6] to 5% in a classification reappraisal by Weis and colleagues in 2009 [7]. Since that time, the advances in the understanding of molecular pathogenesis of the salivary gland neoplasia have led to emergence of new diagnostic entities, which are reflected in the most recent 4th edition of the World Health Organization Classification of Head and Neck Tumours [8].…”

GCDFP-15, AR, and Her-2 as biomarkers for primary ductal adenocarcinoma of the lacrimal gland: a Chinese case and literature review

“…It is extremely rare, as it accounts for only 2% of epithelial lacrimal gland tumors. 1 To our knowledge, there are only 14 de novo cases and one case of ductal adenocarcinoma ex pleomorphic adenoma reported in the literature. 2 – 12 It is important to diagnose ductal adenocarcinomas of the lacrimal gland in their early stages, as they are highly aggressive.…”