Benign mixed tumor of the palpebral lobe of the lacrimal gland. Clinical diagnosis and appropriate surgical management

Abstract

The treatment of suspected benign mixed tumor (pleomorphic adenoma) of the lacrimal gland consists of wide local surgical excision of the tumor and its capsule in their entirety. The tumor should be approached routinely via a lateral orbitotomy to provide maximal exposure and allow complete removal of the lesion. However, if clinical and radiographic evidence indicates a far anterior location implying an origin in the more superficial palpebral lobe, an anterior transcutaneous approach is advantageous and preferred. The authors report an adult case of an anteriorly located benign mixed tumor of the palpebral lobe of the lacrimal gland. The authors reviewed the characteristic clinical, echographic, and computed tomographic (CT) features, offered a differential diagnosis, and described surgical removal using a cryoprobe via an anterior lid approach. An awareness of the distinctive clinical and diagnostic features of benign mixed tumor of the palpebral lobe should help to avoid the complications that ensue from an incisional biopsy or piecemeal resection through the lid, and also to avoid the need for more extensive surgery for removal of residual or recurrent tumor.