Hung S L, Ma L
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Chang Gung Med J. 2000 Feb;23(2):113-7.
Tumors of the lacrimal sac are rare. Benign papillomas comprise approximately 40% of all neoplasms of the lacrimal drainage system. They often present insidiously with symptoms of dacryostenosis or dacryocystitis. Recurrent bouts of dacryocystitis and nasolacrimal duct obstruction were reported in a 35-year-old man over a period of 13 years. A medial canthal mass was noted in the 6th year after the onset of symptoms. A tumor was discovered incidentally during surgical intervention for presumed dacryostenosis. Surgical removal of the tumor and dacryocystorhinostomy were performed. The histopathologic report turned out to be benign papiloma. Local recurrences occurred during the follow-up period. In addition to surgical excision, we applied cryotherapy and CO2 laser to prevent further recurrence. This case we presented the characteristic recurrence of lacrimal sac papilloma and implied the possibility of tumor occurrence in a patient with recurrent dacryocystitis. We must bear in mind that a recurrent dacryocystitis may be a presentation of a lacrimal sac tumor, because early diagnosis and aggressive treatment can prevent recurrence and result in a cure.
泪囊肿瘤较为罕见。良性乳头状瘤约占泪道系统所有肿瘤的40%。它们常隐匿出现，伴有泪道狭窄或泪囊炎的症状。一名35岁男性在13年的时间里反复出现泪囊炎和鼻泪管阻塞。症状出现6年后发现内眦部肿块。在针对疑似泪道狭窄进行手术干预时偶然发现了肿瘤。进行了肿瘤切除及泪囊鼻腔吻合术。组织病理学报告显示为良性乳头状瘤。随访期间出现了局部复发。除手术切除外，我们还应用了冷冻疗法和二氧化碳激光来预防进一步复发。我们呈现的这个病例体现了泪囊乳头状瘤的特征性复发，并提示了复发性泪囊炎患者发生肿瘤的可能性。我们必须牢记，复发性泪囊炎可能是泪囊肿瘤的一种表现，因为早期诊断和积极治疗可预防复发并实现治愈。
