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Campobasso G, Ragno MS, Monda A, Ciccarone S, Maselli del Giudice A, Barbara F, Gravante G, Lucchinelli P, Arosio AD, Volpi L, Bignami M. Exclusive or combined endoscopic approach to tumours of the lower lacrimal pathway: review of the literature. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:S67-S81. [PMID: 38745518 PMCID: PMC11098540 DOI: 10.14639/0392-100x-suppl.1-44-2024-n2966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/06/2024] [Indexed: 05/16/2024]
Abstract
A literature review was conducted to assess the role of minimally-invasive endoscopic treatments for lacrimal pathway neoplasms. The study involved the analysis of 316 patients with benign or malignant tumours affecting the lacrimal drainage system. Histologically, the analysis revealed a prevalence of squamous cell carcinoma, followed by lymphatic neoplasms and melanomas. In terms of treatment, minimally-invasive endoscopic approaches, such as endoscopic dacryocystorhinostomy, play a predominant role in managing early-stage tumours, rather than merely obtaining samples for histological analysis. For more extensive tumours, which constitute the majority of cases, more aggressive external approaches are required, along with the use of adjuvant radiotherapy and chemotherapy. The lack of universally shared staging systems poses a limitation in standardisation and comparison of results. Treatment of these tumours remains complex due to their rarity and histological heterogeneity. A multidisciplinary approach is mandatory to optimise outcomes.
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Affiliation(s)
- Giuseppe Campobasso
- Unit of Otorhinolaryngology, Presidio Ospedaliero “Mons. Dimiccoli”, Barletta, Italy
| | | | | | - Silvana Ciccarone
- Unit of Otorhinolaryngology, Presidio Ospedaliero “Mons. Dimiccoli”, Barletta, Italy
| | | | | | - Giacomo Gravante
- Unit of Otorhinolaryngology, ASST-Sette Laghi, University of Insubria, Varese, Italy
| | - Paolo Lucchinelli
- Unit of Otorhinolaryngology, ASST-Sette Laghi, University of Insubria, Varese, Italy
| | | | - Luca Volpi
- Unit of Otorhinolaryngology, ASST-Lariana, University of Como, Italy
| | - Maurizio Bignami
- Unit of Otorhinolaryngology, ASST-Sette Laghi, University of Insubria, Varese, Italy
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Mo Y, Long D, Li L, Zheng Y. A case report of exophytic nasal papilloma with acute dacryocystitis as the first symptom. BMC Ophthalmol 2021; 21:458. [PMID: 34965868 PMCID: PMC8715150 DOI: 10.1186/s12886-021-02223-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/17/2021] [Indexed: 12/05/2022] Open
Abstract
Background This study aims to explore a case of exophytic nasal papilloma with acute dacryocystitis as the first symptom. Case presentation A 72-year-old male patient complaining of “a 10-year history of tearing and purulent discharge from the right eye, with subsequent redness and pain in the inner canthus for three days” was initially diagnosed with acute dacryocystitis of the right eye. The patient was treated with anti-inflammatory therapy. However, the redness and swelling of the inner canthus continued to increase. An endoscopic dacryocystorhinostomy of the right eye was performed under general anesthesia. A large amount of purulent secretion was drained during the operation. As a result, the swelling of the inner canthus was significantly reduced. A routine intra-operative biopsy of the wall of the lacrimal sac revealed an exophytic nasal papilloma. A second biopsy, 1 week after the surgery, revealed the same result. The patient was advised to undergo a dacryocystectomy once the swelling had subsided. However, the patient was reluctant to undergo this surgery and remains under clinical observation. Conclusion It is rare for an exophytic nasal papilloma, which is a benign tumor in the lacrimal sac, which has the potential for recurrence and malignant transformation, to manifest with acute dacryocystitis as the first symptom. Therefore, this case report could provide a reference for the future clinical diagnosis of this disease.
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Inverted papilloma originating from the lacrimal sac and the nasolacrimal duct with marked FDG accumulation. Radiol Case Rep 2021; 16:3577-3580. [PMID: 34584595 PMCID: PMC8453199 DOI: 10.1016/j.radcr.2021.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Inverted papilloma originating from the lacrimal sac and the nasolacrimal duct is rare, although that in the sinonasal region is a relatively common lesion with local invasion, malignant potential and high recurrence rates after surgery. We report a 52-year-old woman with inverted papilloma of the right lacrimal sac and the nasolacrimal duct, who underwent CT, MR imaging and FDG-PET/CT preoperatively. In addition to CT and MR imaging features similar to those in previous reports, the inverted papilloma exhibited marked FDG accumulation with a maximum standardized uptake value of 7.34 and no other significant FDG accumulation was detected. In summary, our case of inverted papilloma originating from the right lacrimal sac and the nasolacrimal duct noted marked FDG accumulation on PET/CT, which enabled visualization of the localized tumor extension with no metastases.
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Wang J, Ford J, Esmaeli B, Langer P, Esmaili N, Griepentrog GJ, Couch SM, Nguyen J, Gold KG, Duerksen K, Burkat CN, Hartstein ME, Gandhi P, Sobel RK, Moon JY, Barmettler A. Inverted Papilloma of the Orbit and Nasolacrimal System. Ophthalmic Plast Reconstr Surg 2021; 37:161-167. [PMID: 32501879 DOI: 10.1097/iop.0000000000001719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Periocular inverted papilloma (IP) is a rare, locally aggressive tumor with a propensity for recurrence and malignant transformation. Historically treated via wide excision, this study examines the characteristics and management of periocular IP, comparing those confined to the nasolacrimal system with those invading the orbit. METHODS An Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective, comparative case series was conducted in patients with IP of the orbit or nasolacrimal system across 15 clinical sites. RESULTS Of 25 patients, 22 met inclusion criteria with 9 limited to the nasolacrimal system and 13 invading the orbit. Mean age was 60.4 years, 55% were women, all were unilateral. Mean follow-up was 48 months. Rates of smoking, dust and/or aerosol exposure, human papillomavirus (HPV) status, and inflammatory polyps were elevated compared to rates in the general population (45%, 18%, 18%, and 14%, respectively). Bony erosion on computed tomography scans was statistically significantly associated with orbit-invading IP (p = 0.002). Treatment involved all confined IP undergoing surgery alone while 39% of orbit-invading IP also received radiation therapy and/or chemotherapy (p = 0.054). Orbit-invading IP was more likely to be excised with wide margins than IP confined to the nasolacrimal system (85% vs. 22%, p = 0.007). Overall rates of malignancy, recurrence, and patient mortality from IP were found to be 27%, 23%, and 9%, respectively. CONCLUSIONS IP invading the orbit typically requires aggressive therapy, while IP confined to the nasolacrimal system may be treated more conservatively. Using risk factors, characteristics, and outcomes, a treatment algorithm was created to guide management.
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Affiliation(s)
- Jessie Wang
- Montefiore Medical Center, Department of Ophthalmology & Visual Sciences, Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Paul Langer
- New Jersey Medical School, Newark, New Jersey
| | - Neda Esmaili
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Steven M Couch
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - John Nguyen
- West Virginia University, Morgantown, West Virginia
| | | | | | - Cat N Burkat
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Morris E Hartstein
- Shamir Medical Center, Sackler School of Medicine, Be'er Ya'akov, Israel
| | | | - Rachel K Sobel
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jee-Young Moon
- Montefiore Medical Center, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Anne Barmettler
- Montefiore Medical Center, Department of Ophthalmology & Visual Sciences, Albert Einstein College of Medicine, Bronx, New York
- William Beaumont Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, U.S.A
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Mihailovic N, Steenken J, Elges S, Merté RL, Grenzebach U, Eter N, Alnawaiseh M. [Masquerade lacrimal duct stenosis: prevalence of lacrimal sac tumors]. Ophthalmologe 2019; 117:439-444. [PMID: 31520115 DOI: 10.1007/s00347-019-00971-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Tumors of the lacrimal sac are a rare entity. Malignancies are often associated with a high mortality rate. Lacrimal sac tumors often present as lacrimal duct stenosis with dacryocystitis and are often only diagnosed after an intraoperative biopsy. The aim of this study was a retrospective analysis of all cases with lacrimal sac tumors, which presented with a lacrimal duct stenosis at this medical center in the past 10 years. METHODS All patients who were treated by external dacryocystorhinostomy (DCR) at the University Medical Center Münster during the period January 2009-December 2018 were retrospectively analyzed for the presence of a lacrimal sac tumor. Symptoms, clinical and histopathological findings, diagnostic and therapeutic procedures as well as long-term follow-up were analyzed. RESULTS A total number of 878 patients underwent an external DCR at the University Medical Center Münster during the study period. Of these patients 13 were diagnosed with a lacrimal sac tumor and included 9 malignant lymphomas, 2 squamous cell carcinomas, 1 oncocytic adenoma and 1 transitional cell papilloma. CONCLUSION Neoplasms of the lacrimal sac can masquerade as lacrimal duct stenosis or dacryocystitis and must be considered as a differential diagnosis in cases with an atypical clinical course. A lacrimal sac biopsy during an (external) DCR with subsequent histopathological examination is strongly recommended in such cases.
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Affiliation(s)
- Nataša Mihailovic
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland.
| | - Julius Steenken
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Sandra Elges
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Münster, Deutschland
| | - Ralph-Laurent Merté
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Ulrike Grenzebach
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Maged Alnawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
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