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Erkrankungen der Tränendrüse

Diseases of the lacrimal gland

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Zusammenfassung

Aufgrund des seltenen Vorkommens von Tränendrüsenerkrankungen im Praxisalltag ist der Erfahrungswert in der differenzialdiagnostischen Einordnung vergleichsweise gering. Es ist deshalb von besonderer Bedeutung, Richtlinien zu erarbeiten, anhand derer der Kliniker eine Entscheidung treffen kann, ob eine konservative oder operative Therapie erforderlich ist und ob zuvor eine Biopsie zur Diagnosesicherung durchgeführt werden muss. Dabei ist zu berücksichtigen, dass das benigne pleomorphe Adenom durch eine primär komplette Tumorentfernung kurativ behandelt werden kann, während eine Tumorteilresektion, Biopsie oder versehentliche intraoperative Kapseleröffnung ein hohes Rezidivrisiko sowie die Gefahr einer malignen Transformation in sich birgt und somit einen negativen Effekt auf die Langzeitprognose hat. Die präoperativen differenzialdiagnostischen Überlegungen müssen deshalb im Besonderen das mögliche Vorliegen eines pleomorphen Adenoms berücksichtigen. Im Folgenden soll deshalb vor allem auf die differenzialdiagnostischen Aspekte der Tränendrüsenerkrankungen hinsichtlich der klinischen Befunde und der bildgebenden Charakteristika eingegangen werden.

Abstract

Experience with the differential diagnosis of lacrimal gland illnesses is limited in daily practice due to their rarity. It is therefore of particular importance to have guidelines for the practitioner by which he can decide on the application of conservative or surgical therapy, and whether it is necessary to take a biopsy to clarify the diagnosis. There is a wide spectrum of possible illnesses which include systemic diseases, inflammatory disorders, neoplastic, benign and malignant tumors. When a pleomorphic adenoma cannot be excluded, biopsy is contraindicated and complete tumor excision with its capsule is necessary to prevent the possibility of malignant transformation and a negative effect on long-term prognosis. In this overview, special interest is placed on the typical clinical aspects and imaging features of lesions of the lacrimal gland fossa, their differential diagnosis and management.

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  1. Universitäts-Augenklinik Rostock

    N. Fichter, M. Schittkowski & R. F. Guthoff

  2. Universitäts-Augenklinik Rostock, Doberanerstraße 140, 18057, Rostock

    N. Fichter

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Fichter, N., Schittkowski, M. & Guthoff, R.F. Erkrankungen der Tränendrüse. Ophthalmologe 102, 399–425 (2005). https://doi.org/10.1007/s00347-005-1190-x

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