Parnell J R, Mamalis N, Davis R K, Flaharty P M, Anderson R L
Department of Otolaryngology, University of Utah Health Sciences Center, Salt Lake City 84132.
Ophthalmic Plast Reconstr Surg. 1994 Jun;10(2):124-9. doi: 10.1097/00002341-199406000-00010.
A 41-year-old white woman presented with a 1-month history of epiphora and a painless medial canthal mass on the left that was unresponsive to antibiotic treatment. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans delineated a soft tissue mass with bony destruction originating in the area of the left lacrimal sac with extension into the maxillary and ethmoid sinuses and inferomedial orbit. Open biopsy of the mass revealed adenoid cystic carcinoma (ACC). On surgical exploration, the tumor was found to originate from the lacrimal sac wall. Radical surgery with wide excision of surrounding bone and periorbital tissue was performed in light of the histological diagnosis and tumor extension. Orbital exenteration was not performed in order to preserve the patient's left eye. A 6-week course of adjunctive radiotherapy was applied without complication. The patient was clinically and radiologically free of tumor at 1-year follow-up. This case represents only the third time that primary ACC arising from the lacrimal sac has been reported.
一名41岁的白人女性，有1个月的溢泪史，左侧内眦有一无痛性肿块，抗生素治疗无效。计算机断层扫描（CT）和磁共振成像（MRI）扫描显示，起源于左侧泪囊区域的软组织肿块伴有骨质破坏，延伸至上颌窦、筛窦和眶内侧。肿块的开放活检显示为腺样囊性癌（ACC）。手术探查发现肿瘤起源于泪囊壁。根据组织学诊断和肿瘤扩展情况，进行了广泛切除周围骨质和眶周组织的根治性手术。为保留患者左眼，未行眶内容剜除术。给予6周的辅助放疗，无并发症发生。1年随访时，患者临床及影像学检查均未发现肿瘤。该病例是第三次报道原发性泪囊腺样囊性癌。
