UFR médecine, service d'ORL et de chirurgie cervicofaciale, CHU de Clermont-Ferrand, université Clermont 1, BP 69, 63003 Clermont-Ferrand cedex 1, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2010 Nov;127(5):165-72. doi: 10.1016/j.anorl.2010.09.001. Epub 2010 Oct 29.
Lacrimal sac tumors are usually primary and of epithelial origin. Overall, 55% of lacrimal sac tumors are malignant. Mortality rates for malignant tumors depend on tumor stage and type, with a mean rate of 38%. The main objective of this study was to review our experience with these malignancies and to compare this with the published literature.
A 15-year retrospective review of all malignant lacrimal sac tumor patients was completed in our department. Seven patients were found to have malignant sac tumors. The mean age was 53 years (range, 32-74 years) with six women and one man. The patients' clinical records were reviewed for data regarding patient symptoms, preoperative investigations, pathology reports, treatment results, and outcome. These data were compared with the available literature.
All patients presented with epiphora and a palpable lump of the internal canthus. In two cases, a history of recurrent dacryocystitis was noted. The histological types were as follows: squamous cell carcinoma (n=5), one case of adenoid cystic carcinoma, and one case of malignant lymphoma. Surgery was performed in six cases with additional radiotherapy in four. One patient was treated exclusively with external radiotherapy. The mean follow-up was 68 months (range, 6-204 months). Two patients developed recurrences: three were disease-free at the time of the study.
Malignant epithelial lacrimal sac tumors are rare cancers with significant recurrence rates. Correct diagnosis and appropriate therapy require a multidisciplinary management approach. Treatment of these malignant epithelial tumors is first and foremost complete surgical removal with wide excision.
泪囊肿瘤通常为原发性且上皮来源。总体而言，55%的泪囊肿瘤为恶性。恶性肿瘤的死亡率取决于肿瘤分期和类型，平均为 38%。本研究的主要目的是回顾我们对这些恶性肿瘤的经验，并与已发表的文献进行比较。
我们科室对所有恶性泪囊肿瘤患者进行了为期 15 年的回顾性研究。发现 7 例患有恶性囊肿瘤。平均年龄为 53 岁（范围，32-74 岁），有 6 名女性和 1 名男性。回顾患者的临床记录，以获取有关患者症状、术前检查、病理报告、治疗结果和结局的数据。将这些数据与现有文献进行比较。
所有患者均出现溢泪和内眼角可触及的肿块。在 2 例中，有复发性泪囊炎病史。组织学类型如下：鳞状细胞癌（n=5）、腺样囊性癌 1 例和恶性淋巴瘤 1 例。6 例患者行手术治疗，4 例患者行额外放疗。1 例患者仅接受外部放疗。平均随访时间为 68 个月（范围，6-204 个月）。2 例患者复发：3 例在研究时无疾病。
恶性上皮性泪囊肿瘤是罕见的癌症，复发率高。正确的诊断和适当的治疗需要多学科管理方法。这些恶性上皮肿瘤的治疗首先是通过广泛切除进行彻底的手术切除。
