Clinical Analysis of Epithelial Tumors of the Lacrimal Gland

PURPOSE: To analyze the clinical and radiologic findings and to evaluate the treatment and prognosis of epithelial tumor patients. METHODS: We retrospectively reviewed clinical and radiologic findings of 36 patients who had been histopathologically diagnosed with epithelial tumors of the lacrimal gland after biopsy and surgery at Seoul St. Mary's Hospital from May 2005 to October 2012. RESULTS: Among the patients with epithelial tumors of the lacrimal gland based on histopathological findings, there were 21 cases of pleomorphic adenoma, seven cases of dacryops, four cases of adenoid cystic carcinoma, two cases of adenocarcinoma, one case of benign oncocytoma, and one case of mucoepidermoid carcinoma. The characteristic clinical finding of epithelial tumors of the lacrimal gland was proptosis (52.7%). In contrast with benign epithelial tumors of the lacrimal gland, the characteristic clinical findings of malignant epithelial tumors of the lacrimal gland were limitation of motion (57.1%), diplopia (57.1%), ocular pain (42.9%), and decreased visual acuity (42.9%). The mean duration of the symptoms of malignant epithelial tumors (5.0 +/- 4.2 months) was shorter than that of benign epithelial tumors (11.2 +/- 11.1 months) (t-test, p = 0.034). In radiologic CT and MRI findings, there was minimal bony destruction in two cases of pleomorphic adenoma and calcification in one case of pleomorphic adenoma. Malignant epithelial tumors of the lacrimal gland, in contrast to benign tumors, showed characteristic bony destruction (57.1%), poorly marginated tumor outline (42.9%) and calcification (14.3%). The 57.1% of patients in this study with malignant tumors were treated with chemotherapy and radiotherapy after surgical treatment, and there was one case (14.3%) of recurrence after treatment. CONCLUSIONS: Careful analysis of clinical and radiologic findings can lead to early diagnosis of malignant tumors.

Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics

INTRODUCTION: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. MATERIALS AND METHODS: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation , this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. RESULTS: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. CONCLUSION: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.

The Clinical Review of Epithelial Tumors in the Lacrimal Gland

We retrospectively reviewed clinical and radiologic findings of 19 patients who had been diagnosed as epithelial tumors of the lacrimal gland histopathologically after biopsy and surgery at Shinchon Severance Hospital from April, 1991 to July, 1998 and evaluated their correlation to the pathologic diagnosis, treatment and prognosis. There were 7 men and 12 women with the mean age of 41.0+/-13.3 years. Histopathologically, there were 7 cases of adenoid cystic carcinoma, 1 case of adenocarcinoma, 1 case of malignant mixed tumor, 9 cases of pleomorphic adenoma, and 1 case of benign oncocytoma. In comparison with benign epithelial tumor of the lacrimal gland, the characteristic clinical findings of malignant epithelial tumor of the lacrimal gland were pain, limitation of motion, and diplopia[44.4%]. The mean duration of the symptoms of malignant epithelial tumor was shorter[10.3+/-6.6 months] than that of benign epithelial tumor[19.5+/-14.4 months]. In radiologic CT and MRI findings, there were characteristic bony destructions in malignant epithelial tumors of the lacrimal gland[55.6%] compared with benign tumors and poorly marginated outline of the tumor was noted in malignant tumors[44.4%] but not in benign tumors. Therefore, clinical and radiologic findings of epithelial tumors of the lacrimal gland were well correlated with the pathologic diagnosis and would attribute to early diagnosis of malignant tumors.