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

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.