Tumoren der ableitenden Tränenwege

Abstract

Tumours of the lacrimal drainage system are rare. There are several surveys and case reports about tumours in different localisations of the lacrimal drainage system. But we could not find any study which considers all localisations of the lacrimal drainage system. The aim of this study is to give a review of the appearance of tumours of the whole lacrimal drainage system seen during 10 years at the university eye clinic in Münster. We evaluated retrospectively the files of all patients with tumours in the lacrimal drainage system of the university eye clinic in Münster between 1992 and 2002 considering the dignity and type of tumour, the localisation, the symptoms, operation and the anaesthetic procedure. We could find 75 patients with tumours in the lacrimal drainage system, out of which 40 were benign, 25 semi-malignant and 10 malignant tumours. Among the benign tumours were 15 nevus cell nevi, 7 granulation tissue tumours, 5 papillomas, 4 cysts, 1 fibroma, 1 sebborrhoic keratosis, 1 adenoma of secretory duct, 2 inflamed pseudotumours and 2 benign tumours without histopathologic findings. The semi-malignant tumours were exclusively basal cell carcinomas. Among the malignant tumours were 4 lymphomas, 4 carcinomas and 2 malignant melanomas. With regard to the localisation, almost 85 % of all tumours were situated in the upper part of the lacrimal drainage system (upper and lower lacrimal point, upper and lower canaliculus), that means in a location immediately visible for every ophthalmologist. In that site, most of the tumours were of benign or semi-malignant origin. In 15 % of the patients the tumours were located in the lower lacrimal drainage system (lacrimal sac and nasolacrimal duct). More than the half of these tumours were of malignant origin. Tumours of the lacrimal drainage system are rare. Almost 85 % are located in the upper part of the lacrimal drainage system (lower and upper lacrimal point, lower and upper canaliculus) and merely 15 % are located in the lacrimal sac and nasolacrimal duct. These tumours mostly become apparent by symptoms like epiphora. One should be aware of the fact that this symptom can always be masqueraded by a tumour.