| Objective. The purpose of present study was to investgate clinical characters, imaging features and treatments of the epithelial tumor of lacrimal gland.Method. 39 cases histopathologically confirmed to be epithelial tumour of lacrimal gland and documented in the 2nd Hospital of Jilin university ( 2001.1- 2008.9) were retrospectively analyzed. Among them, all the 20 benign cases are proved to be pleomorphic adenoma, but 19 malignant cases consist of 10 cases of adenoid cystic carcinoma, 6 cases of pleomorphic adenoid carcinoma and 3 cases of adenocarcinorma. All the patients'clinical findings, imaging features and treatments were descriptively summarized. The clinical examinations include:vision,intraocular pressure,ocular proptosis,ocular position,ocular movement,anterior segment and ocular fundus. The imaging examinations include:B-scan Ultrasonography,Color Doppler Flow Imaging,Computed Tomography,Magnetic Resonance Imaging. In all cases, patients accepted surgery treatment, but for the malignant cases patients took radiation treatment after surgery.Result. The examination of visual activity showed that 14 patients'vision in malignant group decreased, whereas vision decline only happened to 4 patients in benign group. One patient's IOP was abnormal in benign group, while that happened to 3 cases in malignant group. 16 cases were with exophthalmos in benign group, but 15 cases were with exophthalmos in malignant group . Special signs of the were found as followed: the inward displacement in 9 cases, restricted superduction in 8 cases, restricted introverion in 4 cases , and fixed eye in one case . 15 people who the visual was corrected acuity higher than 0.3,had the double image test, only 1 case had the obvious diplopia.In 12 cases, the tumor could be touched in surface ; 2 cases had the spontaneous pain; fundus to the retina, 5 cases of choroidal folds; 6 cases of ptosis. The malignant epithelial tumors, 9 cases had an obvious shift of the bottom of the eye inward , In 10 cases superduction were restricted ,4 cases introverion were restricted , 3 patients the movement were restricted to all the direction . 7 people who the visual was corrected acuity higher than 0.3,had the double image test, 5 case had the obvious diplopia.In 16 cases, the tumor could be touched in surface ; 16 cases had the spontaneous pain; fundus to the retina, 9 cases of choroidal folds; 8 cases of ptosis.Benign epithelial tumor imaging showed:1,B-mode(20 cases)15 B-mode image were typical example. The tumor were round or oval-shaped. the boundary was clear.The echo were moderately or middle-low level with homogeneous echo. Irregular calcification in tumor were found in 2 case; 1 case had the a liquefid cavity in the tumor. 2,CDFI(8 cases)5 CDFI image were typical example. Blood-rich signal were seen in the tumor.The punctiform,strap shape blood signal in perimeter of the tumor. The blood signal were low in 3 cases with punctiform blood flow signal around the tumor. 3,CT(20 cases) CT examination shows the tumor in the orbital part in 17 cases, palpebral part in 3 cases. 20 cases were expressed as isodensity,the density were uniformity in 17 cases,aniso-density of 3 cases.1 cases shows a low-density cystic areas. Orbital bone depression, deformation in 5 cases. The tumor were enhanced significantly after enhanced.4,MRI(12 cases) MRI examination on T1WI, 3 cases were low signal,9 cases of homo-signal. On T2WI, 3 cases were high signal, 8 cases shows uniformity signal,4 cases of non-uniform signal. After the ontrast injection, the tumor was even enhanced in 7 cases,uneven enhanced in 1 cases.1 case had a cystic degeneration.Malignant epithelial tumor imaging showed:1,B-mode(17 cases)15 B-mode image were typical example. The shape were irregular, the boundary was unclear.The echo were uneven. 2 cases were regular shape,but the echo were uneven.2,CDFI(8 cases)CDFI shows irregular lesions of the lacrimal gland area.There is abundant blood flow signals in the tumor. 3,CT(19 cases)CT examination shows the tumor had irregular shapes.They were expressed as aniso-density.In 9 cases the tumor growed along the orbital wall to the orbital apex, 13 cases showed a moth-eaten bone destruction. Hyperosteogeny were found in 1 case. 2 cases of mass violations encroached the temporal fossa, intracranial. At Ultravist 300 injected contrast agent, the 10 cases in 10 cases of CT were significantly enhanced.4,MRI(18 cases) MRI examination on T1WI, 6 cases were low signal,12 cases of homo-signal. On T2WI, 8 cases were high signal, 10 cases shows homo-signal,After the contrast injection, the tumor was even enhanced in 3 cases,uneven enhanced in 5 cases.1 case had a cystic degeneration. 2 cases of mass violations encroached the temporal fossa, 1 case were encroached intracranial.Benign epithelial tumors, Anterior orbitotomy 6 cases.improvement lateral orbitotomy 14 cases.Malignant epithelial tumors,improvement lateral orbitotomy 14 cases, exenterations 4 cases,Supratentorial craniocerebral Operations with neurosurgeon 1 cases.Malignant epithelial tumors had the radiation therapy after the operation were performed.Conclusion: the lacrimal gland epithelial tumors have the typical clinical features, clinical characteristics by initial diagnosis. B-mode, CDFI, CT, MRI of the lacrimal gland epithelial tumors on the differential diagnosis has significant value. Surgical resection of tumor, postoperative radiotherapy of malignant epithelial lacrimal gland is the most effective tumor treatment.
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