Clinico-radiological features of primary lacrimal gland pleomorphic adenoma: an analysis of 37 cases

Purpose To present the radiological and clinical features of primary lacrimal gland pleomorphic adenoma (PLGPA). Methods Thirty-seven consecutive PLGPAs presenting to two hospitals in Japan were reviewed. Results PLGPA cases had 15 men and 22 women with a mean age of 51.9 years. Common presenting fe...

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Veröffentlicht in:Japanese journal of ophthalmology 2016-07, Vol.60 (4), p.286-293
Hauptverfasser: Watanabe, Akihide, Andrew, Nicholas H., Ueda, Kosuke, Kinoshita, Shigeru, Katori, Nobutada, Reid, Michael, Pirbhai, Adnan, Selva, Dinesh
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container_end_page 293
container_issue 4
container_start_page 286
container_title Japanese journal of ophthalmology
container_volume 60
creator Watanabe, Akihide
Andrew, Nicholas H.
Ueda, Kosuke
Kinoshita, Shigeru
Katori, Nobutada
Reid, Michael
Pirbhai, Adnan
Selva, Dinesh
description Purpose To present the radiological and clinical features of primary lacrimal gland pleomorphic adenoma (PLGPA). Methods Thirty-seven consecutive PLGPAs presenting to two hospitals in Japan were reviewed. Results PLGPA cases had 15 men and 22 women with a mean age of 51.9 years. Common presenting features were ptosis (83 %), diplopia (78 %) and globe displacement (78 %). Twenty-two percent of cases reported symptom duration of less than 6 months, but only 5.6 % of cases had pain. Sixteen percent of PLGPAs were centered in the palpebral lobe; none of which were associated with globe indentation or lacrimal fossa expansion. Bony excavation was observed in 84 % of orbital lobe PLGPA; the bone margin was well demarcated and the character of excavation was more frequently smooth than scalloped (2:1). The presence of globe indentation or bony excavation was associated with increased tumor size ( p  = 0.003). An enhancing rim was visible on T1-weighted fat-suppressed gadolinium-enhanced magnetic resonance imaging (T1FS-Gad MRI) in 27 %. Five (19 %) enclosed cystic spaces were bright on T2-weighted MRI and non-enhancing. Calcification of tumor parenchyma was common in cystic cases but rare in non-cystic cases ( p  = 0.01). Conclusions PLGPAs have varied clinical and radiological features. Common radiological features are a heterogeneous internal architecture on T2-weighted MRI, an enhancing rim on T1FS-Gad MRI, smooth or scalloped bony excavation with intact cortical bone, and globe indentation. Cystic spaces, calcification, and symptom duration less than 6 months are common, but pain is rare. Awareness of the clinico-radiological variants of PLGPA is important when considering incisional biopsy of a lacrimal gland mass.
doi_str_mv 10.1007/s10384-016-0451-3
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Methods Thirty-seven consecutive PLGPAs presenting to two hospitals in Japan were reviewed. Results PLGPA cases had 15 men and 22 women with a mean age of 51.9 years. Common presenting features were ptosis (83 %), diplopia (78 %) and globe displacement (78 %). Twenty-two percent of cases reported symptom duration of less than 6 months, but only 5.6 % of cases had pain. Sixteen percent of PLGPAs were centered in the palpebral lobe; none of which were associated with globe indentation or lacrimal fossa expansion. Bony excavation was observed in 84 % of orbital lobe PLGPA; the bone margin was well demarcated and the character of excavation was more frequently smooth than scalloped (2:1). The presence of globe indentation or bony excavation was associated with increased tumor size ( p  = 0.003). An enhancing rim was visible on T1-weighted fat-suppressed gadolinium-enhanced magnetic resonance imaging (T1FS-Gad MRI) in 27 %. Five (19 %) enclosed cystic spaces were bright on T2-weighted MRI and non-enhancing. Calcification of tumor parenchyma was common in cystic cases but rare in non-cystic cases ( p  = 0.01). Conclusions PLGPAs have varied clinical and radiological features. Common radiological features are a heterogeneous internal architecture on T2-weighted MRI, an enhancing rim on T1FS-Gad MRI, smooth or scalloped bony excavation with intact cortical bone, and globe indentation. Cystic spaces, calcification, and symptom duration less than 6 months are common, but pain is rare. Awareness of the clinico-radiological variants of PLGPA is important when considering incisional biopsy of a lacrimal gland mass.</description><identifier>ISSN: 0021-5155</identifier><identifier>EISSN: 1613-2246</identifier><identifier>DOI: 10.1007/s10384-016-0451-3</identifier><identifier>PMID: 27184391</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Adenoma, Pleomorphic - diagnosis ; Adult ; Aged ; Aged, 80 and over ; Clinical Investigation ; Eye Neoplasms - diagnosis ; Female ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases - diagnosis ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Ophthalmology ; Retrospective Studies ; Tomography, X-Ray Computed - methods ; Young Adult</subject><ispartof>Japanese journal of ophthalmology, 2016-07, Vol.60 (4), p.286-293</ispartof><rights>Japanese Ophthalmological Society 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-f84b2df162e2edf426b17557b70bb543f2cb8712469620e9cbbe620a530c070d3</citedby><cites>FETCH-LOGICAL-c396t-f84b2df162e2edf426b17557b70bb543f2cb8712469620e9cbbe620a530c070d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10384-016-0451-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10384-016-0451-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27184391$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Akihide</creatorcontrib><creatorcontrib>Andrew, Nicholas H.</creatorcontrib><creatorcontrib>Ueda, Kosuke</creatorcontrib><creatorcontrib>Kinoshita, Shigeru</creatorcontrib><creatorcontrib>Katori, Nobutada</creatorcontrib><creatorcontrib>Reid, Michael</creatorcontrib><creatorcontrib>Pirbhai, Adnan</creatorcontrib><creatorcontrib>Selva, Dinesh</creatorcontrib><title>Clinico-radiological features of primary lacrimal gland pleomorphic adenoma: an analysis of 37 cases</title><title>Japanese journal of ophthalmology</title><addtitle>Jpn J Ophthalmol</addtitle><addtitle>Jpn J Ophthalmol</addtitle><description>Purpose To present the radiological and clinical features of primary lacrimal gland pleomorphic adenoma (PLGPA). Methods Thirty-seven consecutive PLGPAs presenting to two hospitals in Japan were reviewed. Results PLGPA cases had 15 men and 22 women with a mean age of 51.9 years. Common presenting features were ptosis (83 %), diplopia (78 %) and globe displacement (78 %). Twenty-two percent of cases reported symptom duration of less than 6 months, but only 5.6 % of cases had pain. Sixteen percent of PLGPAs were centered in the palpebral lobe; none of which were associated with globe indentation or lacrimal fossa expansion. Bony excavation was observed in 84 % of orbital lobe PLGPA; the bone margin was well demarcated and the character of excavation was more frequently smooth than scalloped (2:1). The presence of globe indentation or bony excavation was associated with increased tumor size ( p  = 0.003). An enhancing rim was visible on T1-weighted fat-suppressed gadolinium-enhanced magnetic resonance imaging (T1FS-Gad MRI) in 27 %. Five (19 %) enclosed cystic spaces were bright on T2-weighted MRI and non-enhancing. Calcification of tumor parenchyma was common in cystic cases but rare in non-cystic cases ( p  = 0.01). Conclusions PLGPAs have varied clinical and radiological features. Common radiological features are a heterogeneous internal architecture on T2-weighted MRI, an enhancing rim on T1FS-Gad MRI, smooth or scalloped bony excavation with intact cortical bone, and globe indentation. Cystic spaces, calcification, and symptom duration less than 6 months are common, but pain is rare. 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Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Japanese journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watanabe, Akihide</au><au>Andrew, Nicholas H.</au><au>Ueda, Kosuke</au><au>Kinoshita, Shigeru</au><au>Katori, Nobutada</au><au>Reid, Michael</au><au>Pirbhai, Adnan</au><au>Selva, Dinesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinico-radiological features of primary lacrimal gland pleomorphic adenoma: an analysis of 37 cases</atitle><jtitle>Japanese journal of ophthalmology</jtitle><stitle>Jpn J Ophthalmol</stitle><addtitle>Jpn J Ophthalmol</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>60</volume><issue>4</issue><spage>286</spage><epage>293</epage><pages>286-293</pages><issn>0021-5155</issn><eissn>1613-2246</eissn><abstract>Purpose To present the radiological and clinical features of primary lacrimal gland pleomorphic adenoma (PLGPA). Methods Thirty-seven consecutive PLGPAs presenting to two hospitals in Japan were reviewed. Results PLGPA cases had 15 men and 22 women with a mean age of 51.9 years. Common presenting features were ptosis (83 %), diplopia (78 %) and globe displacement (78 %). Twenty-two percent of cases reported symptom duration of less than 6 months, but only 5.6 % of cases had pain. Sixteen percent of PLGPAs were centered in the palpebral lobe; none of which were associated with globe indentation or lacrimal fossa expansion. Bony excavation was observed in 84 % of orbital lobe PLGPA; the bone margin was well demarcated and the character of excavation was more frequently smooth than scalloped (2:1). The presence of globe indentation or bony excavation was associated with increased tumor size ( p  = 0.003). An enhancing rim was visible on T1-weighted fat-suppressed gadolinium-enhanced magnetic resonance imaging (T1FS-Gad MRI) in 27 %. Five (19 %) enclosed cystic spaces were bright on T2-weighted MRI and non-enhancing. Calcification of tumor parenchyma was common in cystic cases but rare in non-cystic cases ( p  = 0.01). Conclusions PLGPAs have varied clinical and radiological features. Common radiological features are a heterogeneous internal architecture on T2-weighted MRI, an enhancing rim on T1FS-Gad MRI, smooth or scalloped bony excavation with intact cortical bone, and globe indentation. Cystic spaces, calcification, and symptom duration less than 6 months are common, but pain is rare. Awareness of the clinico-radiological variants of PLGPA is important when considering incisional biopsy of a lacrimal gland mass.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>27184391</pmid><doi>10.1007/s10384-016-0451-3</doi><tpages>8</tpages></addata></record>
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subjects Adenoma, Pleomorphic - diagnosis
Adult
Aged
Aged, 80 and over
Clinical Investigation
Eye Neoplasms - diagnosis
Female
Follow-Up Studies
Humans
Lacrimal Apparatus Diseases - diagnosis
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Ophthalmology
Retrospective Studies
Tomography, X-Ray Computed - methods
Young Adult
title Clinico-radiological features of primary lacrimal gland pleomorphic adenoma: an analysis of 37 cases
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