title: Clinicopathologic review of epithelial tumors of the lacrimal gland.
abstract: OBJECTIVE
  To study the clinicopathologic features of epithelial tumors of the lacrimal gland diagnosed at a tertiary care center in India during a 10-year period.
  
  
  METHODS
  Medical records of cases with histopathologically proven epithelial tumors of the lacrimal gland were reviewed for demographic details and clinical features at the time of presentation. For histopathologic findings, slides with hemotoxylin and eosin-stained sections of the tumors were reviewed. Special stains, including histochemical and immunohistochemical stains, and additional sections were studied, whenever needed.
  
  
  RESULTS
  Of 66 cases with epithelial tumors of the lacrimal gland identified during the study period, 50 (76%) cases were benign and 16 (24%) cases were malignant tumors. Histopathologic examination was consistent with the diagnosis of pleomorphic adenoma (PA) in all 50 cases of benign tumors. The mean age at diagnosis in PA cases was 37.7 years. Microscopic examination of PA tumors showed cystic degeneration in 18 (36%) cases, squamous metaplasia in 16 (32%) cases, calcification in 6 (12%) cases, and ossification in 1 (2%) case. Among malignant tumors, adenoid cystic carcinoma (ACC) was the most common tumor (n = 12, 18%), with an average age at diagnosis of 32.4 years. Microscopic examination of ACC revealed that most cases were grade I tumors. Solid areas were noted in 4 (33.3%) cases and perineural invasion was identified in 2 (16.7%) cases. Other malignant tumors included 1 case each of carcinoma ex-PA (1.5%), lacrimal duct carcinoma (1.5%), mucoepidermoid carcinoma (1.5%), and basal cell adenocarcinoma (1.5%).
  
  
  CONCLUSIONS
  As far as the authors are aware, this is the largest series on clinicopathologic features of epithelial tumors of the lacrimal gland from South Asia. The incidence of PA was significantly higher in this study than reported in the Caucasian population. Among malignant tumors, ACCs were the most common, although rare tumors were also identified.
authors.affiliation: *Oculoplastics, Orbit, and Ocular Oncology Service and †Ocular Pathology Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Chawla
authors.forename: Seema
authors.initials: S
authors.lastname: Kashyap
authors.forename: Seema
authors.initials: S
authors.lastname: Sen
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Bajaj
authors.forename: Neelam
authors.initials: N
authors.lastname: Pushker
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Gupta
authors.forename: Mahesh
authors.initials: M
authors.lastname: Chandra
authors.forename: Supriyo
authors.initials: S
authors.lastname: Ghose
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D008949:Adenoma, Pleomorphic / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology; D005134:Eye Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007194:India; D007766:Lacrimal Apparatus Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology*; D012468:Salivary Gland Neoplasms / Q000473:pathology; D055815:Young Adult