Malignant melanomas of the nasolacrimal duct

Melanoma of the lacrimal drainage system: A systematic review

Melanoma of the lacrimal drainage system (LDSM) is a rare and subtle condition that is frequently misdiagnosed. In the present work, we conducted a systematic review investigating the clinical features, management, and prognosis of LDSM. A structured search, according to PRISMA criteria, was performed in April 2020 and updated in February 2021 on Pubmed, EMBASE, Cochrane, and SCOPUS. The articles found underwent a double-reviewer selection and the main data were extracted. After complete screening, 30 articles reporting 38 cases were included. The time from the first symptom to medical contact ranged from 1 month to 4 years. Surgery was the treatment proposed to all patients, with a variable extension of resection. LDSM is a rare disease that is burdened by poor prognosis. Early diagnosis is crucial, even if difficult to achieve. Surgery and radiotherapy are standardized treatments, while targeted therapy and immunotherapy are attractive prospects.

Nasolacrimal duct tumours in the era of endoscopic dacryocystorhinostomy: literature review

Background:

Nasolacrimal duct tumours are rare and are often found inadvertently during dacryocystorhinostomy. Anecdotal case reports have been published, mostly in ophthalmology journals. Since the era of endoscopic dacryocystorhinostomy, such cases are more frequently encountered by ENT surgeons.

Method:

This paper reports a retrospective chart review of patients who underwent endoscopic dacryocystorhinostomy over the last 10 years in our dedicated epiphora clinic. It also provides a systematic literature review of nasolacrimal duct tumour cases published in English over the last 16 years.

Results:

Four of 525 endoscopic dacryocystorhinostomy procedures exposed a tumour (inverted papilloma, oncocytoma, lymphoma and solitary fibrous tumour). The literature review revealed 118 published case reports. Papilloma was the most frequently reported benign tumour and lymphoma was the most common malignant tumour.

Conclusion:

Since the advent of endoscopic dacryocystorhinostomy, tumours are being diagnosed relatively early when smaller in size. Because of the rarity of this condition, it is advisable that such cases are managed through a dedicated epiphora service framework.