Lacrimal gland and fossa masses: evaluation by computed tomography and A-mode echography

Although masses of the lacrimal gland and fossa are accurately localized by CT, their appearances are often similar making differentiation between various pathological entities difficult. We examined 32 patients with CT and/or standardized A-mode echography (SAE) to determine if SAE added significant information to that supplied by CT alone. Other than five cases of dermoid cysts, which were fat containing, and one case of lacrimal gland pseudotumor, which had associated uveal scleral thickening and enhancement, there was no specific CT pattern that allowed a definite diagnosis. SAE reflectivity patterns, however, allowed separation of masses into the following categories: pseudotumor/lymphoma, carcinoma/metastasis, benign mixed adenoma, lymphangioma, and dermoid cyst. We conclude that SAE is an important adjunct to CT in the diagnosis of lacrimal gland/fossa masses that are not fat containing.