2023 Volume 116 Issue 8 Pages 765-773
Background: Carcinomas of the lacrimal drainage system are rarely encountered/reported. More than half of the tumors of the lacrimal drainage system are malignant, and squamous cell carcinoma is the most common histological type. Initially, it is often difficult to distinguish this cancer from chronic inflammation, and it takes an average of 3 years from the onset to diagnosis. The tumor is usually treated by surgery and postoperative irradiation or chemoradiation therapy. Excision including the orbit and paranasal sinuses is necessary for advanced tumors. Human papilloma virus (HPV) has been reported to contribute to the development of carcinoma of the lacrimal drainage system. We report three cases of carcinoma of the lacrimal drainage system.
Method: Case report and literature review.
Results: Of the three cases, the carcinoma arose from the lacrimal sac in two cases, and from the nasolacrimal duct in one case. In 2 of the three cases, the tumor was extensive and grew relatively rapidly, and we selected extended combined resection, including orbital contents removal, and reconstructive surgery as the treatment. In 1 case, the extent of progression was limited, and function preservation was possible by chemoradiation therapy alone. HPV was detected in 2 cases, including in one case each of carcinoma of the lacrimal sac and carcinoma of the nasolacrimal duct.
Conclusion: For tumors of the lacrimal drainage system, early diagnosis and therapeutic intervention are desirable. Therefore, repeated biopsies and cooperation with other departments are necessary. Probing possible HPV involvement in carcinoma of the lacrimal drainage system may be useful for diagnosis.
