Pal Sandeep, Patidar Narendra, R Ashik, Arora Agrawal Poonam, Tekam Dev Kumar
Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalaya, Chitrakoot, Uttar Pradesh, India.
Department of Pathology, Central Laboratory, Indore, Madhya Pradesh, India.
SAGE Open Med Case Rep. 2024 Nov 16;12:2050313X241271787. doi: 10.1177/2050313X241271787. eCollection 2024.
Lacrimal sac and nasolacrimal duct tumors are extremely rare, and most of them are malignant tumors, which are often misdiagnosed as chronic dacryocystitis. We herein report a rare case of a 29-year-old female, presented with a history of watering in the right eye associated with a rapidly progressive mass for 4 months near the medial canthus. Further clinical examination revealed firm, non-tender mass occupying the lacrimal sac fossa extending above the medial canthus. The systemic examination was unremarkable, with a palpable right submandibular lymph node palpable. Contrast-enhanced computerized tomography (CECT) orbit revealed a well-defined mass at the medial canthus extending into the osseous nasolacrimal canal. An excision biopsy was performed, and histopathology revealed a poorly differentiated sebaceous carcinoma of the lacrimal sac. The oncologist advised CECT chest, face, and neck post-surgery, which revealed malignant neoplastic changes at the right lacrimal sac region and lacrimal duct with metastasis at right nodes I b, II, V, and left nodes I b and II. Five-month follow-up showed no signs of recurrence.
泪囊和鼻泪管肿瘤极为罕见,且大多数为恶性肿瘤,常被误诊为慢性泪囊炎。我们在此报告一例罕见病例,一名29岁女性,有右眼流泪病史,内眦附近有一快速进展的肿物4个月。进一步临床检查发现,在内眦上方泪囊窝处有一质地硬、无压痛的肿物。全身检查无异常,但可触及右侧颌下淋巴结。眼眶增强计算机断层扫描(CECT)显示内眦处有一界限清楚的肿物,延伸至骨性鼻泪管。进行了切除活检,组织病理学显示为泪囊低分化皮脂腺癌。肿瘤学家建议术后进行胸部、面部和颈部CECT检查,结果显示右侧泪囊区和泪管有恶性肿瘤改变,右侧Ib、II、V区及左侧Ib和II区淋巴结有转移。五个月的随访显示无复发迹象。