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Lacrimal Gland

1. Rules for Classification

There should be histological confirmation of the disease and division of cases by histological type.

The following are the procedures for assessing T, N, and M categories:

T categories. Physical examination and imaging
N categories. Physical examination
M categories. Physical examination and imaging

2. Regional Lymph Nodes

The regional lymph nodes are the preauricular, submandibular, and cervical lymph nodes.

3. TNM Clinical Classification

3.1. T - Primary Tumour

TX. Primary tumour cannot be assessed
T0. No evidence of primary tumour
T1. Tumour 2.5 cm or less in greatest dimension, limited to lacrimal gland
T2. Tumour more than 2.5 cm, but not more than 5 cm, in greatest dimension limited to lacrimal gland
T3. Tumour invades periosteum
     T3a. Tumour not more than 5 cm invades periosteum of lacrimal gland fossa
     T3b. Tumour more than 5 cm in greatest dimension with periosteal invasion
T4. Tumour invades orbital soft tissues, optic nerve, or globe with or without bone invasion; tumour extends beyond orbit to adjacent structures including brain

3.2. N - Regional Lymph Nodes

NX. Regional lymph nodes cannot be assessed
N0. No regional lymph node metastasis
N1. Regional lymph node metastasis

3.3. M - Distant Metastasis

MX. Distant metastasis cannot be assessed
M0. No distant metastasis
M1. Distant metastasis

4. pTNM Pathological Classification

The pT, pN, and pM categories correspond to the T, N, and M categories.

5. G Histopathological Grading

GX. Grade of differentiation cannot be assessed
G1. Well differentiated
G2. Moderately differentiated; includes adenoid cystic carcinoma without basaloid (solid) pattern
G3. Poorly differentiated; includes adenoid cystic carcinoma with basaloid (solid) pattern
G4. Undifferentiated

6. Stage Grouping

No stage grouping is at present recommended.

7. Summary

Lacrimal Gland Carcinoma
T1
≤2.5 cm, limited to gland
T2
>2.5 to 5 cm, limited to gland
T3
Periosteum
T3a
Periosteum ≤5 cm
T3b
Periosteum >5 cm
T4
Orbit and beyond
N1
Regional