Adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct: a case report

• Published in: The Laryngoscope Vol. 113; no. 6; p. 940
• Main Authors: Baredes, Soly, Ludwin, Danielle B, Troublefield, Yolanda L, Langer, Paul D, Mirani, Neena
• Format: Journal Article
• Language: English
• Published: United States 01.06.2003
• Subjects: Adenoma, Pleomorphic - diagnostic imaging; Adenoma, Pleomorphic - pathology; Adenoma, Pleomorphic - radiotherapy; Adenoma, Pleomorphic - surgery; Biomarkers, Tumor - analysis; Biopsy; Combined Modality Therapy; Dacryocystorhinostomy; Eye Neoplasms - diagnostic imaging; Eye Neoplasms - pathology; Eye Neoplasms - radiotherapy; Eye Neoplasms - surgery; Humans; Lacrimal Apparatus Diseases - diagnostic imaging; Lacrimal Apparatus Diseases - pathology; Lacrimal Apparatus Diseases - radiotherapy; Lacrimal Apparatus Diseases - surgery; Male; Middle Aged; Nasolacrimal Duct - diagnostic imaging; Nasolacrimal Duct - pathology; Nasolacrimal Duct - surgery; Radiotherapy, Adjuvant; Tomography, X-Ray Computed
• ISSN: 0023-852X
• DOI: 10.1097/00005537-200306000-00005

To present the clinical presentation, workup, surgical approach, and pathological findings of the first case report of a patient with adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct. Retrospective review of the records of a case of adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct. The clinical presentation, workup, surgical approach, and pathological findings were reviewed. A 51-year-old man presented with a 10-year history of recurrent epiphora of the right eye. At dacryocystorhinostomy a small lesion was visualized within the lumen of the lacrimal sac. A biopsy specimen was consistent with adenocarcinoma. En bloc resection was accomplished using a lateral rhinotomy and medial maxillectomy. The final specimen showed adenocarcinoma ex-pleomorphic adenoma. The patient was given postoperative radiation therapy. He was free of disease 16 months after treatment. Lacrimal sac tumors should be considered in the differential diagnosis of chronic epiphora. Management of nasolacrimal adenocarcinoma requires complete surgical resection. Radiation treatment in and of itself is not curative but may be useful as adjuvant therapy. Carcinoma ex-pleomorphic adenoma can develop in the lacrimal sac and nasolacrimal duct.