Mucoepidermoid carcinoma of the lacrimal gland: 25 cases and a review and update of the literature.

Twenty-five cases of mucoepidermoid carcinoma of the lacrimal gland are compiled, the largest series reported to date. Five of these have not been previously reported. Additional follow-up is presented for seven cases previously reported in the literature, and 13 other cases from the literature are reviewed. This study suggests that histologic grading of the tumor into low- (grades 1 and 2) and high-grade (grade 3) tumors is most predictive of prognosis and can be used to formulate a therapeutic plan. Of the 16 patients with a known histologic grade for their tumors, 8 had low-grade tumors and 7 of these patients survived after extirpation with or without radiotherapy. On the other hand, only 1 of the 8 patients with high-grade tumors for which extended follow-up was available has remained tumor free. The authors suggest that low-grade tumors can be treated with complete extirpation with or without adjuvant radiation and that these tumors generally have a good prognosis. Grade 3 tumors, on the other hand, may be treated aggressively with exenteration and excision of bone, if needed, as well as adjuvant radiation. But these tumors, despite this treatment, carry a poor prognosis.