Transcranial Approach for Removal of Pleomorphic Adenoma of Lacrimal Gland

Kim, Hyung Keun; Kim, Hyeon Sook; Cho, Nam Chun

Abstract

Pleomorphic adenoma in lacrimal gland is a rare disease. Injuries to capsule surrounding the tumor lead to recurrence or malignant transformation of tumor by seeding of tumor cells into adjacent tissues. Therefore complete removal of tumor without any injury to capsule is important. We present 2 cases of pleomorphic adenoma of lacrimal gland with symptoms of exophthalmos, hypophthalmos and supraduction limitation. We performed frontatemporal craniotomy and removed orbital roof for the exposure of the tumor located at superior portion of orbit. We removed the tumor with intact capsule avoiding any damage to superior levator palebral muscle and superior rectus muscle microscopically. Periosteum of superior orbital roof was repaired and frontal bone was repositioned. As a result, patients had no symptoms of exophthalmos, hypophthalmos and supraduction limitation. There are no complications of ptosis, diplopia, dry eye syndrome, symblepharon and scar on the face. Transcranial approach for removal of pleomorphic adenoma of lacrimal gland provides wide exposure of the tumor for complete removal of the mass without any damage to surrounding tissues and good cosmetic effects.