Epithelial lacrimal gland tumors: pathologic classification and current understanding

Area of Science:

• Ophthalmology
• Pathology
• Oncology

Background:

• Lacrimal gland tumors require accurate classification for diagnosis and treatment.
• Existing classification schemes may not fully encompass the diversity of epithelial lacrimal gland neoplasms.
• The World Health Organization (WHO) classification of salivary gland tumors has been recently updated.

Purpose of the Study:

• To adapt and apply the updated epithelial salivary gland classification scheme to a large cohort of lacrimal gland tumors.
• To establish an updated classification scheme for lacrimal gland tumors.
• To evaluate the utility of the revised classification in a clinical setting.

Main Methods:

• A retrospective multicenter cohort study involving 118 cases of epithelial neoplasia of the lacrimal gland.
• Pathologic analysis, subtyping, and survival data were collected and analyzed.
• The updated salivary gland tumor classification scheme was applied to all cases.

Main Results:

• 17% (14%) of the 118 cases were reclassified using the expanded scheme.
• Pleomorphic adenoma and adenoid cystic carcinoma were the most frequent neoplasms identified.
• Unusual histologic features were noted, and three tumors remained unclassifiable, with two exhibiting malignant characteristics.

Conclusions:

• The updated salivary gland tumor classification is applicable to epithelial lacrimal gland neoplasms.
• The expanded classification led to reclassification in 14% of cases, enhancing diagnostic precision.
• Current practices lack consistent pathologic standards for evaluating lacrimal gland lesions, necessitating further standardization.