Son Seung-Myoung, Woo Chang Gok
Department of Pathology, Chungbuk National University Hospital, Cheongju, Korea.
Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea.
J Int Med Res. 2024 Dec;52(12):3000605241310843. doi: 10.1177/03000605241310843.
Adenoid cystic carcinoma (ACC) rarely occurs in the nasolacrimal duct (NLD), and when it does, it has nonspecific manifestations. To the best of our knowledge, one case of ACC in the NLD has been reported in the literature. Herein, we report a second case of ACC in the left NLD, concerning a man in his late 60s. He presented with epiphora, and swelling and pain below the left medial canthus. Nasal endoscopy revealed bulging of the lateral wall in the left nasal cavity, with an intact nasal mucosa. Paranasal sinus computed tomography showed an enhancing mass at the epicenter of the left NLD, involving the maxillary sinus, inferior turbinate, and nasal cavity, with bony destruction. The patient underwent superomedial maxillectomy. The pathology was high-grade ACC. Despite undergoing five rounds of postoperative radiotherapy, the ACC recurred 11 months after the operation. Early identification is critical for reducing the morbidity and mortality of patients with ACC in the NLD.
腺样囊性癌（ACC）很少发生于鼻泪管（NLD），一旦发生，症状不具有特异性。据我们所知，文献中仅报道过1例鼻泪管腺样囊性癌。在此，我们报告1例发生于左侧鼻泪管的腺样囊性癌，患者为60多岁男性。他表现为溢泪，左侧内眦下方肿胀、疼痛。鼻内镜检查显示左侧鼻腔外侧壁膨隆，鼻黏膜完整。鼻窦计算机断层扫描显示左侧鼻泪管中心有一强化肿块，累及上颌窦、下鼻甲和鼻腔，并伴有骨质破坏。患者接受了上颌骨内侧切除术。病理结果为高级别腺样囊性癌。尽管术后接受了5轮放疗，但腺样囊性癌在术后11个月复发。早期识别对于降低鼻泪管腺样囊性癌患者的发病率和死亡率至关重要。
