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Klin Monbl Augenheilkd 2002; 219(8): 602-608
DOI: 10.1055/s-2002-34424
Kasuistik
© Georg Thieme Verlag Stuttgart · New York

Tränennasenwegsstenose durch ein Zylindrom

Beschreibung einer ungewöhnlichen Tumormanifestation und LiteraturüberblickNasolacrimal Duct Obstruction Caused by a CylindromaReport of an Atypical Tumor Manifestation and Review of the LiteratureMichael  Schittkowski1 , Gerhard  Stropahl2 , Angela  Timm1 , Rudolf  Guthoff1
  • 1Universitätsaugenklinik Rostock
  • 2Institut für Pathologie, Universität Rostock
Further Information

Publication History

Eingegangen: 17. Dezember 2001

Angenommen: 25. Juli 2002

Publication Date:
27 September 2002 (online)

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Zusammenfassung

Hintergrund: Ziel der vorliegenden Arbeit ist es, Klinik, Diagnostik und Therapie sowie die histologischen Befunde eines Patienten mit einer durch ein Zylindrom verursachten postsakkalen Tränennasenwegsstenose darzustellen. Die bisher publizierten Reviewartikel sowie die aus der Medline-Datenbank recherchierten Einzelfallpublikationen von insgesamt 618 Tränensackneoplasien werden zusammengefasst. Kasuistik: Ein 79-jähriger Patient litt seit über 40 Jahren unter multiplen Zylindromen (Spiegler-Tumoren) des Kopfes. Er stellte sich mit seit sechs Monaten bestehender linksseitiger Epiphora vor und berichtete über einen Tumor wechselnder Größe im Bereich des Tränensackes. Während der Dakryozystorhinostomie zeigte sich eine Raumforderung, die den Übergang des Tränensackes in den Ductus nasolacrimalis verschloss. Nach kompletter Exzision ergab die histopathologische Beurteilung ein Zylindrom, das vermutlich ausgehend von der Dermis zu einem expansiven Wachstum in den Bereich des Tränensackes geführt hatte. Der Patient ist seit der Operation beschwerdefrei. Schlussfolgerung: In die Differenzialdiagnose der postsakkalen Tränennasenwegsstenose muss eine tumorbedingte Genese miteinbezogen werden. Nach unserem Kenntnisstand ist diese Kasuistik die erste Beschreibung einer postsakkalen Tränennasenwegsstenose, die durch ein Zylindrom verursacht wurde.

Abstract

Background: The purpose of this report is to describe the clinical characteristics, management and histological findings in a patient with obstruction of the nasolacrimal duct caused by a cylindroma. About 618 lacrimal sac tumours have been reported previously in reviews and case reports, which were reviewed after searching in medline database. Case report: A 79-year old man suffered from multiple cylindromas (Spiegler tumour) on his head for about 40 years. He presented with a 6 months' history of left-sided epiphora and a painless medial canthal mass of various size. A tumour which caused nasolacrimal duct obstruction was found during dacryocystorhinostomy. After complete excision histological examination revealed a cylindroma, which had shown expansive growth from dermis to the lacrimal sac area. The patient felt well; there was no longer any epiphora or dacryocystitis after the operation. Conclusion: Although very rare, lacrimal sac tumours must be considered in the differential diagnosis of nasolacrimal duct obstruction. To our knowledge this case represents the first report on an atypical manifestation on a Spiegler tumour in the lacrimal sac region.

Schlüsselwörter

Zylindrom - Spiegler-Tumor - Epiphora - Tränensacktumor - Tränenwegsstenose

Key words

Cylindroma - Spiegler tumour - epiphora - lacrimal sac tumour - nasolacrimal duct obstruction

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Dr. med. M. Schittkowski

Universitätsaugenklinik

Doberaner Straße 140

18057 Rostock

Email: michael.schittkowski@med.uni-rostock.de