What Is Lacrimal Gland Tumor

Executive Summary

The lacrimal gland tumor is located above and to the side of the eye, and these are tear secreting glands. It mainly occurs in one in a million people and is more common in people with an average age of 40 years. These tumor lesions appear similar to the lesions in the major salivary glands. These tumors or neoplasms are broadly classified into two- epithelial and non-epithelial lacrimal gland tumors. The epithelial lacrimal tumors can be divided into benign and malignant lacrimal gland tumors. The different types of lacrimal gland tumors include benign mixed epithelial tumors, malignant mixed epithelial tumors, lymphoma, and adenoid Cystic Carcinoma (ACC). Other less common malignancies affecting the lacrimal gland include mucoepidermoid carcinoma, primary adenocarcinoma lymphoepithelial carcinoma, myoepithelial carcinoma etc.

What is a lacrimal gland tumor?

The lacrimal gland tumor are located above and to the side of the eye, and these are tear secreting glands ​1​. When the cells in the gland undergo mutation, they grow and divide uncontrollably, resulting in the formation of a mass or lump called a tumor. A tumor could be categorized as benign or malignant. A benign tumor refers to a less aggressive tumor that grows but doesn’t metastasise to other body regions. And a malignant tumor refers to a cancerous tumor capable of invading and spreading to other body parts.

Lacrimal gland tumors are seen to occur in one in a million people. The tumor can occur in people of any age, but it is more common in people with an average age of 40 years. Middle-aged people are more susceptible to the tumor than the young or the elderly. These tumor lesions appear similar to the lesions in the major salivary glands. These tumors or neoplasms are broadly classified into two- epithelial and non-epithelial lacrimal gland tumors. Further, the epithelial lacrimal tumors can be divided into benign and malignant lacrimal gland tumors. Out of the total epithelial lacrimal gland tumors, around 45% are malignant, and 55% are seen to be benign. 

TYPES OF LACRIMAL GLAND TUMOUR

Lacrimal gland tumors can be of different types. The doctor will determine the tumor type and then design the apt treatment strategy. The types of lacrimal gland tumor are ​2​:

  • Benign mixed epithelial tumor: Benign mixed epithelial tumors are non-cancerous. They don’t usually metastasise to different body parts but can grow uncontrollably if not treated at the right time. The type of tumor usually begins in the cells that line the lacrimal gland. A benign epithelial tumor can either be a ductal epithelial cyst (dacryops) or pleomorphic adenoma (benign mixed tumor) ​3​. Pleomorphic adenoma is a benign epithelial lesion likely to affect the lacrimal gland.
  • Malignant mixed epithelial tumor: Malignant mixed epithelial lacrimal gland tumors also start in the cells that line the gland ​4​. These tumors are more aggressive than benign ones. If left untreated, they can metastasise and affect different body parts. Pleomorphic adenocarcinoma is a malignant mixed tumor type.
  • Lymphoma: A lymphoma can affect different regions of the eye. But they are more likely to affect the lacrimal glands and the conjunctiva. Conjunctiva refers to the mucous membrane that lines the inner surfaces of the eyelids and the outer surface of the white part of the eye. Non-Hodgkin lymphoma is the most common type of lymphoma affecting the eyes. It may also be associated with the central nervous system (CNS) or systemic lymphoma.
  • Adenoid Cystic Carcinoma (ACC): ACC is the common most malignant epithelial neoplasm affecting the lacrimal gland. Adenoid cystic carcinoma is a rare type of adenocarcinoma. ACC, in general, refers to any cancerous growth that starts in the glandular tissues. An ACC tumor has a distinctive pattern, where bundles of epithelial cells infiltrate, surround or invade glandular structures or ducts of different organs. When adenoid cystic carcinoma occurs in the eye’s lacrimal gland, it causes the eye to bulge out. This condition is referred to as proptosis. Another feature of an ACC tumor in the lacrimal gland is pain that affects the local nerves due to the growing tumor ​5​.

Other less common malignancies affecting the lacrimal gland include mucoepidermoid carcinoma, primary adenocarcinoma lymphoepithelial carcinoma, myoepithelial carcinoma etc.

References

  1. 1.
    An Update on Tumors of the Lacrimal Gland. Asia Pac J Ophthalmol (Phila). Published online 2017. doi:10.22608/apo.201707
  2. 2.
    von Holstein SL, Rasmussen PK, Heegaard S. Tumors of the lacrimal gland. Seminars in Diagnostic Pathology. Published online May 2016:156-163. doi:10.1053/j.semdp.2015.10.002
  3. 3.
    Baek S, Lee JS, Lee H, Chang M, Park M. Benign mixed tumor of the lacrimal sac. Indian J Ophthalmol. Published online 2015:282. doi:10.4103/0301-4738.156940
  4. 4.
    Font RL. Malignant Epithelial Tumors of the Lacrimal Gland. Arch Ophthalmol. Published online May 1, 1998:613. doi:10.1001/archopht.116.5.613
  5. 5.
    Argyris PP, Pambuccian SE, Cayci Z, Singh C, Tosios KI, Koutlas IG. Lacrimal Gland Adenoid Cystic Carcinoma with High-Grade Transformation to Myoepithelial Carcinoma: Report of a Case and Review of Literature. Head and Neck Pathol. Published online July 25, 2012:85-92. doi:10.1007/s12105-012-0383-2