Lacrimal Sac Tumors: A case series

AbstractObjective:To describe a new endonasal dacryocystorhinostomy technique and to assess its efficacy.Design:Prospective, non-randomised, interventional case series.Patients and methods:Patients with primary nasolacrimal duct obstruction were included. A prospective series of 226 consecutive endoscopic transnasal dacryocystorhinostomies performed between January 2003 and December 2006 were entered into the study. Patients who had undergone previous lacrimal surgery were excluded. The surgical technique involved the creation of nasal mucosal and large posterior lacrimal flaps at the medial lacrimal sac wall. The two flaps were placed in close apposition. The technique also involved creation of a large bony ostium.Main outcome measures:Success was defined as the resolution of symptoms, or unobstructed lacrimal irrigation and endoscopic visualisation of a patent rhinostomy.Results:A total of 226 consecutive endoscopic transnasal dacryocystorhinostomy procedures performed between January 2003 and December 2006 were reviewed. The main presentation was with epiphora (95 per cent) and/or mucocele (13 per cent). Septoplasty was performed in 36 per cent of cases at the time of surgery. In 18 per cent of cases, endoscopic sinus surgery was also added to the procedure. The follow-up period ranged from six months to two years. Of the 226 patients, eight were lost to follow up and were thus excluded from the series. The procedure achieved a 92 per cent success rate, in terms of symptom relief and anatomical success.Conclusion:The described technique of endoscopic endonasal dacryocystorhinostomy had a success rate comparable to that of external dacryocystorhinostomy. The procedure is simple and cost-effective because it does not require sophisticated equipment such as lasers, optical fibres, silicone stents or a microdebrider.

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Dacryocystectomy as a treatment alternative for chronic recurrent dacryocystitis in elderly patients: case series study

OphthaTherapy Therapies in Ophthalmology ◽

10.24292/01.ot.220520 ◽

2020 ◽

Vol 7 (2) ◽

pp. 129-134

Author(s):

Anna Kwiecińska ◽

Małgorzata Woś

Keyword(s):

Elderly Patients ◽

Gold Standard ◽

Case Series ◽

Lacrimal Sac ◽

Treatment Alternative ◽

Lacrimal System ◽

Case Series Study ◽

Series Study ◽

Minimally Invasive Methods ◽

Surgical Extirpation

Dacryocystectomy is a procedure that involves complete surgical extirpation of the lacrimal sac. It was first described by Woolhouse in 1724 and became the gold standard for the management of lacrimal system obstruction and dacryocystitis before the advent of dacryocystectomy. Many minimally invasive methods are currently available to treat lacrimal disorders, but there are several specific indications for dacryocystectomy, such as malignant lacrimal sac tumors. Generally, the procedure is performed under local anesthesia, which avoids risks that are associated with general anesthesia or sedation in ailing or elderly patients. Dacryocystectomy can also also avoid skin scars. In 2013, Shams and Selva were the first to perform endoscopic dacryocystectomy. This article discusses indications, contraindications, goals, techniques, and complications of dacryocystectomy.

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Mucoepidermoid Carcinoma of the Lacrimal Sac: Clinical-Pathologic Analysis, Including Molecular Genetics

Ocular Oncology and Pathology ◽

10.1159/000502699 ◽

2019 ◽

Vol 6 (2) ◽

pp. 138-144 ◽

Cited By ~ 2

Author(s):

Kalla A. Gervasio ◽

Paul J.L. Zhang ◽

Robert B. Penne ◽

Mary A. Stefanyszyn ◽

Ralph C. Eagle Jr. ◽

...

Keyword(s):

Salivary Gland ◽

Mucoepidermoid Carcinoma ◽

Gene Fusion ◽

Case Series ◽

Radical Resection ◽

Clinical Findings ◽

Lacrimal Sac ◽

Egfr Amplification ◽

Pathologic Analysis

Purpose: The aim of this study was to assess whether mucoepidermoid carcinoma of the lacrimal sac is a counterpart of CRTC1/3-MAML2 gene fusion-related salivary gland mucoepidermoid carcinoma. Methods: In this retrospective observational case series, pathology records were searched for all cases of lacrimal sac mucoepidermoid carcinoma diagnosed between 1990 and 2018. Data collected included demographics, clinical findings, management, and follow-up. Pathologic parameters assessed included tumor morphology, immunohistochemistry, and MAML2 and EGFR fluorescence in situ hybridization (FISH) studies. Results: Six patients with mucoepidermoid carcinoma of the lacrimal sac, 5 males and 1 female, with a median age of 63 years (range 24–66) were identified. Five tumors were managed with radical resection and 1 patient underwent orbital exenteration. None of the patients developed recurrence or metastases with an average follow-up of 18 months (range 13–23). All tumors had morphologic and immunohistochemical features of mucoepidermoid carcinoma and overexpressed EGFR. MAML2 FISH was negative for MAML2 rearrangement in all tumors. EGFR FISH demonstrated EGFR amplification in 1 tumor. Conclusions: Mucoepidermoid carcinoma of the lacrimal sac is not a lacrimal sac counterpart of CRTC1/3-MAML2 gene fusion-related salivary gland mucoepidermoid carcinoma. EGFR pathway activation and EGFR amplification in a subset of these neoplasms suggest the potential role for anti-EGFR agents.

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Lacrimal Sac Rhinosporidiosis and Surgical Management by Transnasal Endoscopic Excision: A Case Series

The Laryngoscope ◽

10.1002/lary.27322 ◽

2018 ◽

Vol 128 (12) ◽

pp. 2693-2696 ◽

Cited By ~ 2

Author(s):

George Rajesh Raju ◽

Suresh Sandeep

Keyword(s):

Surgical Management ◽

Case Series ◽

Lacrimal Sac ◽

Endoscopic Excision

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Lacrimal sac lymphoma: A series of Japanese patients

European Journal of Ophthalmology ◽

10.1177/1120672118803510 ◽

2018 ◽

Vol 29 (6) ◽

pp. 678-684 ◽

Cited By ~ 3

Author(s):

Maria Suzanne Sabundayo ◽

Yasuhiro Takahashi ◽

Hirohiko Kakizaki

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Case Series ◽

B Cell Lymphoma ◽

Japanese Patients ◽

Nasolacrimal Duct ◽

Lacrimal Sac ◽

Retrospective Case ◽

Large B Cell Lymphoma ◽

Large B Cell

Purpose: To present cases of primary lacrimal sac lymphoma in a Japanese population. Methods: In this retrospective case series, five cases (two males and three females; mean age: 49.8 years; age range: 38–62 years) were included. Clinical features, diagnostic findings, and treatment outcomes were collected and reviewed. Results: Most patients presented with a swelling or mass in the medial canthal area. Only one patient presented with epiphora, while another patient also complained of pain which was due to inflammation. Imaging studies revealed a lacrimal sac mass with involvement of the nasolacrimal duct and variable involvement of the nasal cavity. Histopathological findings revealed three cases of diffuse large B-cell lymphoma, one case of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, and one case of follicular lymphoma. Four cases were treated with a combination of chemotherapy and immunotherapy, with one case necessitating additional radiotherapy. One case was treated with immunotherapy alone. The mean follow-up was 23 (range: 3–50) months. Four cases showed complete remission, while the remaining patient is still ongoing treatment. Conclusion: Diffuse large B-cell lymphoma is the most common type of lacrimal sac lymphoma in this series. Lacrimal sac tumors should be ruled out in the presence of epiphora, dacryocystitis, or a mass in the medial canthus, even in the absence of pain or bleeding. Combined chemotherapy and immunotherapy is an effective treatment for these cases.

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