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Evaluation and Management of Lacrimal Gland Diseases

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

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Abstract

The lacrimal gland is the epicenter of a broad spectrum of neoplastic and inflammatory diseases (Table 58.1). Space occupying lesions of the lacrimal gland and its fossa constitute approximately 5–13% of orbital masses upon biopsy [1–3]. Based primarily on Reese’s [4] 1956 clinicopathologic survey of 112 consecutive expanding lesions of the lacrimal gland, most authorities generally report that approximately 50% of the lesions originate from epithelial elements of the lacrimal gland and 50% are of non-epithelial origin [5–7]. Of non-epithelial lesions, 50% are lymphoid tumors and 50% are comprised of various infections and inflammatory pseudotumors. Among the epithelial tumors of the lacrimal gland, approximately 50% are pleomorphic adenomas (benign mixed tumors), 25% adenoid cystic carcinoma, and the remainders are other types of carcinoma. Recent reports, however, suggest that inflammatory lesions and lymphoid tumors are more common, and that epithelial malignancies of the lacrimal gland are considerably less frequent than commonly cited, ranging from 22% to 47% [1, 3, 7–10]. Proper differentiation between these two groups is of paramount importance since several of the lesions are life threatening.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA

    David T. Tse M.D., F.A.C.S.

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  1. David T. Tse M.D., F.A.C.S.
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Correspondence to David T. Tse M.D., F.A.C.S. .

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Editors and Affiliations

  1. Department of Ophthalmology, Associate Professor of Ophthalmology Wayne State University School of Med, Detroit, Michigan, USA

    Evan H. Black

  2. Oakland University William Beaumont, Clinical Professor of Ophthalmology Director, Oculoplastic Surgery, Southfield, Michigan, USA

    Frank A. Nesi

  3. Department of Ophthalmology, University of Central Florida, Orlando, USA

    Christopher J. Calvano

  4. William Beaumont School of Medicine, Clinical Professor of Ophthalmology Co-Director, Oculoplastic Surgery, Detroit, Michigan, USA

    Geoffrey J. Gladstone

  5. Former Chief of Ophthalmology, Emeritus Clinical Prof of Ophthalmology Case Western Reserve University, South Euclid, USA

    Mark R. Levine

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Tse, D.T. (2012). Evaluation and Management of Lacrimal Gland Diseases. In: Black, E., Nesi, F., Calvano, C., Gladstone, G., Levine, M. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0971-7_58

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