Abstract
Purpose To compare the clinical characteristics and treatment outcome between benign and malignant lacrimal sac tumors. Methods We retrospectively reviewed the medical records of all patients with pathologically confirmed lacrimal sac lesions from 1995 to 2018 in a tertiary medical center. Results Among 65 eligible cases, 46 (70.8%) were benign lacrimal sac tumors and 19 (29.2%) were malignant lacrimal sac tumors. Secondary malignancy from nasal or paranasal cancer accounted for 47% of malignant lacrimal sac tumors. The patient's mean age at the time of diagnosis was 60 years in the benign group and 48 years in the malignant group (p=0.03). The most common presenting symptoms were a palpable lump/mass and epiphora in both groups. Palpable mass extending above the medial canthal tendon was noted in 9% of the benign group and in 74% of the malignant group, respectively (p=0.03). The most common presenting symptoms were a palpable lump/mass and epiphora in both groups. Palpable mass extending above the medial canthal tendon was noted in 9% of the benign group and in 74% of the malignant group, respectively (p=0.03). The most common presenting symptoms were a palpable lump/mass and epiphora in both groups. Palpable mass extending above the medial canthal tendon was noted in 9% of the benign group and in 74% of the malignant group, respectively (p=0.03). The most common presenting symptoms were a palpable lump/mass and epiphora in both groups. Palpable mass extending above the medial canthal tendon was noted in 9% of the benign group and in 74% of the malignant group, respectively (Conclusion Although benign and malignant lacrimal sac tumors may present similar initial symptoms, timely diagnosis and intervention for malignant lacrimal sac lesions are important because they tend to be infiltrating tumors with a poor outcome.
Highlights
Lacrimal sac tumors are relatively rare compared to other ocular adnexal tumors
Our study revealed that the initial presenting symptoms such as epiphora and a lump or swelling in the lacrimal sac area are often similar in both benign and malignant lacrimal sac lesions
Tumor mass extending above the medial canthal tendon remained an important red flag sign suggestive of malignant lacrimal sac tumors
Summary
Lacrimal sac tumors are relatively rare compared to other ocular adnexal tumors. Diagnosis of these tumors is often delayed because they are usually confused with inflammatory dacryocystitis [1,2,3,4,5,6]. Because of its location between paranasal sinus and the orbit, lacrimal sac tumor is less noticeable during its initial stage than eyelid tumor or conjunctival tumor. Most published studies mainly focused on malignant lacrimal sac tumors. We compare the clinical characteristics and treatment outcome between benign and malignant lacrimal sac tumors
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