Natural history
- Can behave like adenoid cystic carcinoma with intracranial and perineural invasion
- Can have tumor-related death when intervention is delayed.
- Usually identified relatively early in tumor progression because of the harbinger pleomorphic adenoma.
Medical therapy
There is no known effective chemotherapeutic or immunobiologic regimen for this tumor.
Radiation
- No studies have assessed the impact of radiation therapy on lacrimal gland malignant mixed tumor.
- For invasive parotid malignant mixed tumor, adjunctive radiation has been shown to improve local recurrence rates (Chen 2007).
Surgery
- There has been no large case series.
- Outcomes are good for noninvasive and minimally invasive disease after surgery, even without adjuvant radiation (Bernardini 2008).
Common treatment responses, follow-up strategies
- With minimally invasive and in situ disease surgical cure can be achieved with wide excision.
- Early perineural invasion and bony involvement are not seen; this differs from adenoid cystic carcinoma.
- Local and distant spread can be seen with continued tumor progression beyond the encapsulated mass.