Lacrimal Sac Tumor-Report of Two Cases

Abstract

Purpose: To report two cases of rare primary lacrimal sac tumor-one of inverted papilloma and the other of hemangiopericytoma. Method: Case report Results: An 84-year-old male patient presented with persistent epiphora of the left eye for many years and nasolacrimal duct obstruction with dacryocystitis was diagnosed. During external dacryocystorhinostomy, a soft tissue mass was visualized in the lacrimal sac and nasolacrimal duct incidentally. Excisional biopsy was performed and histopathologic examination reported an inverted papilloma. Lateral rhinotomy and medial maxillectomy with meticulous removal of all mucosa in the ipsilateral paranasal sinuses were performed subsequently. No recurrence was noted during a follow-up period of 4 years. A41-year-old female patient visited our hospital for a progressive painless bulging mass above the right medial canthal area for half a year and chronic epiphora of the right eye for 2 years. Computed tomography of paranasal sinuses demonstrated a solid tumor within the right lacrimal sac. Endonasal dacryocystorhinostomy was performed to remove the tumor by an otolaryngologist and the histopathologic examination reported a hemangiopericytoma. Recurrence was noted after one-year follow-up. Excision of recurred tumor via endoscopic method was performed. At 2 years follow-up, no recurrence was noted. Conclusion: Lacrimal sac tumors are rare. Pathologic study of dacryocy-storhinostomy specimen is not indicated routinely but is recommended in unusual cases. In malignant cases, an extended surgery and long-term follow-up for recurrence and metastasis are required.