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Treatment of primary lymphoma of the lacrimal gland by surgical excision alone: A 5-year follow-up study

Research Authors
Abd El-Nasser A. Mohammad, Sana S. Kroosh
Research Department
Research Journal
Orbit
Research Member
Research Rank
1
Research Vol
Volume 20 - Number 2
Research Website
http://informahealthcare.com/doi/abs/10.1076/orbi.20.2.131.2639
Research Year
2001
Research_Pages
131-140
Research Abstract

PURPOSE . To evaluate the long-term efficacy of surgical excision alone in the treatment of non-Hodgkin¹s lymphoma localized to the lacrimal gland. MATERIALS AND METHODS . Thirteen patients with primary lacrimal gland lymphoma were included. The presumptive diagnosis was based on: (1) The painless and relatively slow onset of unilateral lacrimal gland swelling, mostly in elderly adults; (2) The CT pattern of a soft tissue mass in the lacrimal gland region with defined margins and molds to the globe; (3) The negative results of systemic work-up. The involved lacrimal gland was excised via an anterior trans-septal approach in 12 cases and by lateral canthotomy, upper cantholysis, and a trans-periosteal approach in one case. Following histopathologic confirmation of the diagnosis, no supplemental therapy was given. The patients were followed for a minimum of 5 years (5–8 years). RESULTS . In all patients, the excised lacrimal gland lymphoma was firm, nodular and appeared encapsulated. The histologic subtypes of the excised masses were: low-grade lymphomas in 11 cases (7 small lymphocytic, 3 plasmacytoid lymphocytic, 1 follicular small cleaved) and intermediate grade in 2 cases (1 follicular large cell and 1 diffuse small cleaved). No evidence of local recurrence or systemic dissemination was reported during the follow-up period in any of the patients. CONCLUSIONS . Surgical excision of the tumor is a new curative technique for lymphoma localized to the lacrimal gland without any other orbital or systemic involvement. By this technique, orbital radiotherapy and its potential ocular complications can be avoided. However, more study is recommended.