Orbitocranial resection for treatment of lacrimal gland malignant tumors with intracranial extension

Abstract

Objectives This study reports our experience with multidisciplinary surgical management of lacrimal gland malignant tumors with intracranial extension using the orbitocranial approach. Methods We reviewed treatment strategies and surgical approaches for lacrimal gland malignant tumors with intracranial extension and present 2 illustrative patients who underwent orbitocranial resection at our institution in 2015. Clinical records, radiographic images, histologic sections, and archived pathology specimens were reviewed. Results Both patients underwent orbitocranial tumor resection, followed by postoperative chemoradiotherapy. Orbital reconstruction was performed using a temporalis fascia flap and split calvarial bone grafts, with split-thickness skin grafting to line the orbital cavity. The follow-up periods were 69- and 66-months, respectively. Both patients remained alive without evidence of disease recurrence during follow-up. Conclusions The orbitocranial approach, combined with postoperative chemoradiotherapy, may provide satisfactory local and regional control in selected patients with lacrimal gland malignant tumors with intracranial extension. Long-term surveillance remains important because patients may remain at risk for disease recurrence or distant metastasis.