泪腺肿瘤38例临床分析

目的：分析泪腺肿瘤的临床特点和治疗结果。方法：回顾性研究38例45眼泪腺肿瘤。结果38例45眼中，男17例17眼，女21例28眼；年龄5～63岁，平均40．6岁；其中泪腺癌5眼，腺样囊性癌5眼。恶性泪腺混合瘤5眼，良性泪腺混合瘤14眼，炎性假瘤13眼，慢性泪腺炎2眼，泪腺潴留性囊肿1眼。42眼行前路或侧壁开眶肿瘤摘除术，恶性肿瘤中4眼行眶内容物剜除。恶性肿瘤患者全部于术后1个月接受放疗。术后随访观察3个月～8年。术后症状完全缓解35眼，好转5眼，复发5眼。结论：泪腺肿瘤为眼眶常见肿瘤，结合病史，临床表现和影像学检查。绝大部分可以作出术前定性诊断，良性泪腺混合瘤预后较好，但易复发。恶性泪腺混合瘤及腺样囊性癌复发率、死亡率较高，应联合眶内容物剜除，放疗及化疗。

The clinical features and therapy of lacrimal gland tumor

Objective To summarize the clinical features and therapeutic strategy of lacrimal gland tumor.Methods The clinical records of 45 eyes of 38 patients with lacrimal gland tumor were retrospectively reviewed.Results There were 17 eyes of 17 male and 28 eyes of 21 female in our patients.The age range from 5 to 63 years,averaging 40 6 years.The pathological examination showed that:5 specimens were lacrimal gland carcinoma,5 were adenoid cystic carcinoma of laceimal gland,5 were malignant mixed tumor of lacrimal gland,14 were benign mixed tumor,13 were inflammatory pseudotumor,2 were chronic dacryoadenitis,and 1 were retentive cyst.Anterior or lateral orbitotomy were performed on 42 of 45 patients.Orbital exanteration were performed on 4 patients with malignant neoplasm.All eyes of malignant tumor received radiotherapy 1 month after operation.The patients were followed up from 3 months to 8 eyars.Follow-up results revealed that 35 patients recoveried completely and 5 partly,while another 5 patients recured.Conclusions Lacrimal gland tumor was one of the most common orbit tumor.Preoperative diagnosis can be made in most cases based on case history,clinical manifestation and imaging findings.Benign mixed tumor of lacrimal gland had good prognosis but recurrence was common.Malignant mixed tumor and adenoid cystic carcinoma of lacrimal gland had high recrudescent and mortality rates,and should be treated by a combined orbital exenteration with local radiotherapy and systemic chemotherapy.