King Khaled Eye Specialist Hospital, Saudi Arabia
Dr. Hind Manaa Alkatan, MD has completed her Ophthalmology Board in the year 1994 from King Saud University, Riyadh, Saudi Arabia and postdoctoral studies from Departments of Ophthalmology/Pathology, University of Manitoba and University of British Columbia, Canada in the year 1999. She is a Senior Academic Consultant Ophthalmologist and the Chair of the Pathology and Laboratory Medicine Department at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. She has published more than 55 papers in reputed journals and serving as an editorial board member of the Saudi Journal of Ophthalmology and the World Journal of Ophthalmology.
Aim: To study the prevalence, clinicopathological and radiological correlations of epithelial lacrimal gland tumors and compare these with similar published literature. The study was also designed to look at the natural history of benign mixed tumors (BMT) in regards to recurrence and malignant degeneration. Methods: This was a retrospective study of all suspected epithelial tumors of the lacrimal gland surgically excised at King Khaled Eye Specialist Hospital (KKESH) for the period: 1983 – 2008. Exclusion criteria included structural lesions (dacryops) and inflammatory lesions. We included 26 cases of epithelial lacrimal gland tumors (from 24 patients). The histopathologic slides and the radiologic findings were reviewed. The corresponding demographic and clinical data was obtained by chart review using a data sheet. Results: BMT accounted for 12/26 of the lesions while malignant lesions including adenoid cystic carcinoma (ACC) were more common (14/26). The mean age was 44.27 years (range 12-75). Commonest clinical presentation was proptosis. Median duration of symptoms in the BMT cases was 30 months and 7 months in the ACC group. The 12 BMT cases were primary in 9 and recurrent in 3 patients. The 11 ACC cases showed mostly cribriform pattern and low histopathologic grade. We had 2 cases of malignant mixed tumor (MMT) one of which arising in a recurrent tumor. One case of primary mucoepidermoid carcinoma with histopathologic grade 2 was noted. Radiologically, a well-defined appearance with bone remodeling was observed in BMT in contrast to invasive appearance with destruction in malignant lesions. Conclusion: Our series information indicated a different distribution of benign and malignant epithelial lesions with a slightly higher rate of malignancy. BMT was the commonest benign tumor where recurrence was a squeal of incomplete surgical excision. ACC was the commonest malignant tumor with shorter duration of symptoms and radiologic evidence of invasiveness that correlated with the histopathologic features.