• Oculoplastics/Orbit

    This study describes the clinical and imaging features of primary lacrimal gland pleomorphic adenoma (PLGPA), recurrent LGPA (RLGPA) and lacrimal gland malignant epithelial tumors (LGMET).

    Study design

    The authors performed a single institution, retrospective study. A total of 64 patients with LGPA (55 primary and 9 recurrent) and 36 patients with LGMET were identified. Clinical and imaging features were investigated via CT and MRI to determine differences between the conditions.


    There were no differences in age, gender or laterality between the groups. Patients with LGMET had a shorter duration of symptoms (7.1 months) than those with either PLGPA (23.9 months) or RLGPA (127.1 months). Patients with LGMET or RLGPA were more likely to have ill-defined margins and demonstrate heterogeneity on CT scans than those with PLGPA (all P<0.001). Patients with RLGPA were more likely to have calcification than those with LGMET, who were in turn more likely to have calcification than those with PLGPA. Patients with LGMET or RLGPA were most likely to have bony invasion. On MRI, those with LGMET were most likely to have a tail or wedge sign, indicating infiltration into the posterior orbit.


    This is one of the largest studies of the imaging characteristics of lacrimal gland malignancies. Although not a stated purpose of the study, it would have been helpful to describe the clinical outcomes associated with the imaging characteristics.

    Clinical significance

    It is critical to differentiate between lacrimal gland malignancies when planning surgical procedures. This study provides valuable information that can help clinicians determine the likelihood of each of the entities based on clinical and radiological findings.