ABSTRACT
Prior to the advent of histopathology, there was no distinction between various types of epithelial tumors of the lacrimal gland, and thus no valid basis for clinical prognostication regarding specific types. Warthin, in his review of 132 cases in 1901, came to the conclusion that many previous diagnoses could be subsumed under the diagnosis of mixed tumor (1). As recently as 1939, this trend continued with the publication of a series by Sanders of 12 cases of mixed tumor with no distinction between benign and malignant lesions, even though the clinical outcome varied tremendously between cases (2). In 1948, a series by Godtfredsen was the first to distinguish benign from malignant lacrimal gland tumors according to histologic features, and to note that the clinical prognosis was different for the two classes (3). Since that time, classification schemes have evolved with a general trend toward more specific histopathologic diagnoses. Duke-Elder and MacFaul listed seven diagnoses in 1974 (4), and the most recent World Health Organization (WHO) classification of 1980 similarly lists seven diagnoses (5) (Table 1).
