Surgical Management of Adenoid Cystic Carcinoma of the Lacrimal Gland

Abstract

Abstract: : Purpose: To highlight a multi–disciplinary approach to the management of adenoid cystic carcinoma of the lacrimal gland. Methods: A retrospective case series of 10 patients with lacrimal gland adenoid cystic carcinoma treated at The University of Texas M. D. Anderson Cancer Center between January 2000 and November 2003. Clinical records, histologic sections, radiographic images, treatment modalities, and the metastatic sites were reviewed in each patient. Results: The study included 4 men and 6 women (mean age at diagnosis, 39.5 years). The clinical features, radiographic findings, presence of bony erosion and/or perineural invasion will be discussed for this cohort. In all but one patient radical orbitectomy was performed. 8 patients had removal of orbital roof and lateral wall at the time of orbitectomy. All patients underwent reconstruction of the socket using a vascularized flap and post–operative adjuvant radiotherapy 4–6 weeks after surgery. The surgical approach, which involved a neurosurgeon, an oculoplastic surgeon, and a plastic surgeon will be discussed. The radiation field included the orbit as well as the skull base due to the high prevalence of perineural invasion. Conclusions: The rationale for our treatment approach will be discussed. Illustrative cases highlighting the metastatic behavior of this cancer will be featured.

Keywords: lacrimal gland • oncology • tumors