A Case of Nasolacrimal Duct Carcinoma

Abstract

Background: Malignancies of the nasolacrimal apparatus are rare and usually originate from the lacrimal sac. To the best of our knowledge, malignant tumors arising from the nasolacrimal duct are extremely rare. We encountered a patient with squamous cell carcinoma arising from the nasolacrimal duct. Herein, we report this case of nasolacrimal duct carcinoma.

Case: A 65-year-old man presented with a 3-month history of blood-stained lacrimation on the right side. Nasal endoscopy revealed an exophytic lesion occupying the right inferior meatus. Imaging studies showed an expansible lesion involving the nasolacrimal duct and the inferior meatus, but not invading the orbit or adjacent soft tissues. A biopsy was suggestive of squamous cell carcinoma. We performed radical resection through Denker’s approach under endoscopic guidance. Due to the close margins, we also administered postoperative radiation therapy (PORT) for the local lesion. Four months later, we performed conservative neck dissection (I–V) for cervical lymph node metastases. Due to multiple lymph node metastasis, PORT was also administered for the neck lesion. Until now, 2 years after completion of PORT, there has been no evidence of disease recurrence.

Conclusion: We encountered a case of squamous cell carcinoma originating from the nasolacrimal duct, which was controlled while preserving the visual function. CT/MRI imaging and intraoperative endoscopic findings were useful to determine the appropriate extent of resection.