A Comprehensive Guide to Lacrimal Gland Tumor

The lacrimal gland is situated near the outer corner of the eye. This gland plays a pivotal role in tear production, ensuring the eyes remain moist and well-lubricated. Although relatively rare, tumors can develop in the lacrimal gland and significantly impact an individual’s overall well-being. This kind of tumor comprises only 10% of all orbital masses. 

In this blog post, we will share a comprehensive understanding of lacrimal gland tumors and the potential implications they can have on a person's vision and quality of life. Read on to learn more. 

Common Types of Lacrimal Gland Tumors

1. Pleomorphic Adenoma

Also known as the benign mixed tumor, pleomorphic adenoma is the most common lacrimal gland tumor. These tumors typically arise from the epithelial cells of the lacrimal gland and contain a mix of various tissue types. Although they are usually benign, if left untreated or inadequately managed, they may recur or, in rare cases, undergo malignant transformation. 

2. Adenoid Cystic Carcinoma

Unlike pleomorphic adenomas, adenoid cystic carcinoma is a malignant lacrimal gland tumor that grows slowly but relentlessly. It is a cancerous tumor that originates from the gland's secretory cells and can infiltrate nearby structures. Due to its aggressive nature and ability to invade nerves, complete surgical removal is often challenging for this tumor, making it more difficult to treat. 

3. Lymphoma

It is a type of cancer that can affect the lacrimal gland and surrounding tissues. It arises from abnormal lymphocytes, which are a type of white blood cell involved in the body's immune response. Lacrimal gland lymphomas may occur as primary lymphomas confined to the eye region or as part of a systemic lymphoma affecting other parts of the body.  

Causes and Risk Factors

The exact cause of lacrimal gland tumors remains unknown till date. However, lacrimal gland tumors affect individuals in their 40s or 60s. Lymphoma, a cancer that increases the risk of developing lacrimal gland lymphoma, is more common in individuals around the age of 70. 

While researchers are still trying to identify the exact risk factors behind the formation of lacrimal gland tumors, radiation exposure, or lymphoma, systemic diseases may have the potential to increase the risk. 

How Does Lacrimal Gland Tumor Affect Tear Production?  

When a tumor develops within or around the lacrimal gland, the following factors can influence tear production: 

1. Compression

As the tumor grows, it can compress or infiltrate the lacrimal gland, disrupting tear production. 

2. Tear duct obstruction

Some lacrimal gland tumors can cause blockages in the tear drainage system, preventing tears from properly draining away from the eye.  

3. Inflammation

The presence of a tumor in or near the lacrimal gland can lead to localized inflammation, eventually affecting tear production and the normal functioning of the lacrimal gland. 

4. Neurological impact

In certain cases, lacrimal gland tumors may affect the nerves that control tear production.  

The specific impact of lacrimal gland tumors on tear production can vary depending on the type, size, and location of the lacrimal gland tumor.  

Lacrimal Gland Tumors Symptoms

• Eye swelling or protrusion 

• Excessive tearing and watery eyes 

• The presence of a lump near the lacrimal gland area, towards the outer part of the eyelids 

• Visual disturbances, which may manifest as double or blurred vision 

• Pain experienced around one eye 

Diagnostic Methods and Tests for Lacrimal Gland Tumors

1. Physical examination

First, an ophthalmologist generally assesses the affected eye and surrounding structures for any noticeable abnormalities. They may check for eye swelling, asymmetry, or lumps near the lacrimal gland area. Additionally, healthcare providers may ask for medical history and any related symptoms individuals have been experiencing. 

2. Imaging studies

To gain a detailed view of the lacrimal gland and its surrounding tissues, healthcare providers usually recommend imaging studies like Magnetic Resonance Imaging (MRI) and Computed Tomography (CT scan). These non-invasive techniques allow healthcare professionals to visualize the tumor's size, location, and extent of involvement. These tests can also help determine whether the tumor is benign or malignant. 

3. Biopsy and histopathological examination

When a tumor is detected in the lacrimal gland, oncologists usually perform a biopsy for a definite diagnosis. They obtain a small tissue sample for analysis and sent it for histopathological examination. 

Treatment Options for Lacrimal Gland Tumors

1. Surgical interventions

a. Local tumor excision

For small, localized tumors that are benign or show no signs of malignancy, a surgical procedure known as local tumor excision may be recommended. During the surgery, surgeons remove the tumor and a small amount of surrounding healthy tissue. 

b. Orbital exenteration 

In more advanced cases or when the tumor shows signs of invasiveness, oncologists consider orbital exenteration. This is an extensive surgery in which the entire contents of the eye socket, including the eye, eyelids, and lacrimal gland, are removed.  

Orbital exenteration is typically reserved for aggressive or recurrent tumors that are regarded as life threatening or compromise the surrounding structures. 

c. Dacryocystorhinostomy (DCR)

In some cases, lacrimal gland tumors may lead to blockages in the tear drainage system, causing discomfort and excessive or less watering of the eyes. Dacryocystorhinostomy is a surgical procedure that creates a new tear drainage pathway from the eye to the nasal cavity, bypassing the blocked area.  

While dacryocystorhinostomy is not a direct treatment for the tumor, it can significantly improve tear drainage and alleviate symptoms. 

2. Radiation therapy

This traditional cancer treatment option involves the targeted use of high-energy beams to destroy cancer cells and shrink tumors. External beam radiation therapy can be employed to treat lacrimal gland tumors, especially when surgery is not a suitable option, or as an adjuvant treatment following surgery to reduce the risk of recurrence.  

3. Chemotherapy

It is a systemic treatment that uses powerful medications to target and destroy cancer cells throughout the body. It may be used for lacrimal gland tumors that have spread to other parts of the body or in cases where surgery and radiation therapy are insufficient in controlling the tumor's growth. Chemotherapy may be administered alone or in combination with other treatments, depending on the tumor's type and stage. 

Treatment decisions for lacrimal gland tumors are highly individualized and depend on factors such as the tumor's size, location, type, and whether it has spread to other areas. Individuals should consult a multidisciplinary team of healthcare professionals, including ophthalmologists, oncologists, and surgeons to develop the most suitable treatment plan tailored to their specific condition. 

Potential Complications

1. Vision loss 

Lacrimal gland tumors, especially those that grow extensively or involve nearby structures, can lead to vision loss. As the tumor grows, it may exert pressure on the optic nerve or other critical eye structures, causing visual disturbances, such as blurriness, double vision, or even partial or complete loss of vision.  

2. Facial deformities 

Advanced lacrimal gland tumors can cause facial deformities due to their proximity to the eye socket and surrounding facial structures. Tumors that infiltrate or spread to nearby tissues may alter the shape and appearance of the eye, eyelids, and surrounding areas. 

3. Recurrence of tumors 

Despite successful treatment, some lacrimal gland tumors have a tendency to recur. The risk of recurrence depends on various factors, including the tumor's type, stage, and the effectiveness of the initial treatment. Regular follow-up visits and monitoring are crucial in detecting any signs of tumor recurrence early on and ensuring timely intervention. 

The potential complications associated with lacrimal gland tumors can vary widely depending on individual factors and the specific characteristics of the tumor. Therefore, individuals should discuss this with their cancer care team to get detailed information. 

The Bottom Line

Although these tumors are not entirely preventable, prioritizing eye health with regular check-ups can go a long way to reducing its risk. It will also help in detecting any issues early on and help prevent severe complications.  For any queries or concerns about lacrimal gland tumors, contact ACTC, one of the best cancer centers in Florida, offering personalized cancer treatment plans.