Lacrimal gland tumours: the role of CT and conventional radiology

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Abstract
The X-ray features of 66 [human] lacrimal gland comprising 32 benign pleomorphic adenomas, 24 carcinomas and 10 lymphomas are reviewed. The role of radiology in the management of these patients is discussed. Although lacrimal gland tumors present no unique radiological appearances the diagnosis and pathological type may be suggested by a combination of conventional radiography and CT [computed tomography] scan. It is important to distinguish the pleomorphic adenoma clinically and radiologically from other lesions of the lacrimal gland since this tumor must be excised in toto. Incisional biopsy or partial removal may result in a disastrous recurrence with seeding into bone and soft tissue. X-ray signs of malignancy in lacrimal gland tumors include invasion and sclerosis of the adjacent bone of the lacrimal fossa, calcification in the tumor and extension outside the lacrimal gland area shown on CT scan. The pre-operative diagnosis of malignancy was improved from 42 to 73% by CT. Indentation or enlargement of the lacrimal fossa was seen in 80% of benign pleomorphic adenomas. Although non-specific, this sign in a patient with a painless lacrimal gland swelling of > 12 mo. duration without radiological evidence of malignancy is strongly indicative of a benign tumor.

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