von Goscinski C, Koch K R, Cursiefen C, Heindl L M
Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
HNO. 2016 Jun;64(6):386-93. doi: 10.1007/s00106-016-0162-6.
The prevalence of tumors affecting the lacrimal drainage system is low, thus generating a risk of late diagnosis and treatment in clinical routine. However, these tumors can be potentially life-threatening, which emphasizes the relevance of early diagnosis and treatment.
This review focuses on the symptoms, incidence, management, and prognosis of the different tumor entities affecting the lacrimal drainage system.
The study provides a PubMed-based literature review and presents own clinical results.
Alongside detailed medical history taking and comprehensive clinical examination, precise inspection during external dacryocystography is important for diagnosis of tumors affecting the lacrimal drainage system. There is a wide spectrum of tumor entities located in the lacrimal drainage system. The tumors are classified into three groups: primary epithelial, primary nonepithelial, and inflammatory lesions. The most common primary epithelial tumors include papilloma, squamous cell carcinoma, and transitional cell carcinoma. The most common nonepithelial tumors include fibrous histiocytoma, malignant lymphoma, and malignant melanoma; while the most common inflammatory lesions comprise sarcoidosis, Wegener granulomatosis, and pyogenic granuloma. Treatment depends on the entity and stage of the tumor. In the case of malignancy, a multimodal and interdisciplinary approach is usually indicated.
Differential diagnostic signs in favor of a malignancy include a long medical history, predisposing conditions in the patient's history, a mass above the medial canthal ligament, teleangiectasis above the mass, and serosanguinous secretion.
影响泪道系统的肿瘤患病率较低,因此在临床常规诊疗中存在诊断和治疗延迟的风险。然而,这些肿瘤可能会危及生命,这凸显了早期诊断和治疗的重要性。
本综述聚焦于影响泪道系统的不同肿瘤实体的症状、发病率、治疗及预后。
本研究基于PubMed进行文献综述并展示自身临床结果。
除详细的病史采集和全面的临床检查外,泪道造影时的精确检查对于诊断影响泪道系统的肿瘤很重要。泪道系统存在多种肿瘤实体。这些肿瘤分为三组:原发性上皮性、原发性非上皮性和炎性病变。最常见的原发性上皮性肿瘤包括乳头状瘤、鳞状细胞癌和移行细胞癌。最常见的非上皮性肿瘤包括纤维组织细胞瘤、恶性淋巴瘤和恶性黑色素瘤;而最常见的炎性病变包括结节病、韦格纳肉芽肿和化脓性肉芽肿。治疗取决于肿瘤的类型和分期。对于恶性肿瘤,通常需要采取多模式和跨学科的方法。
提示恶性肿瘤的鉴别诊断体征包括病史较长、患者病史中的易感因素、内眦韧带上方的肿块、肿块上方的毛细血管扩张以及血性浆液性分泌物。