Orbital lobe resection provides a definite diagnosis of lacrimal gland lesions: A report of three cases

Background: Entities of lacrimal gland lesions comprise almost inflammatory and lymphoproliferative processes as well as benign and malign tumors and usually cannot be differentiated by magnetic resonance imaging (MRI) exclusively. Hence, representative tissue samples are needed to arrive at sufficient histopathological diagnosis for further treatment decisions. Case report: Three women aged between 18 and 67 years were admitted to our centre with clinical signs of a space-occupying mass in the lacrimal fossa. MRI revealed a circumscribed lacrimal gland lesion in all three cases. The orbital lobe was resected through a lateral orbitotomy approach for histopathological evaluation. Findings confirmed the diagnoses of pleomorphic adenoma, dacryoadenitis and low-grade B-cell non-Hodgkin's lymphoma. Further surgery was not necessary. No recurrence or symptoms of 'dry eye' were observed over the course of a 1-year follow-up. Conclusion: In cases of non-specific masses in the lacrimal gland on MRI, histopathological diagnoses are vital and can be sufficiently provided by resection of the orbital lobe. Symptoms of 'dry eye' are uncommon and secondary surgical intervention can be avoided in cases of the presented entities. Further studies with larger patient cohorts are warranted to confirm these findings. Keywords: lacrimal gland, orbital lobe, dry eye, orbitotomy, MRI, dacryoadenitis