Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(03): 447-450
DOI: 10.4103/ijmpo.ijmpo_154_17
Practitioner Section

Transitional Cell Carcinoma of Lacrimal Sac Presenting as a Massive Swelling and Dacryohemorrhea

Abhishek Purkayastha
Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
,
Neelam Sharma
Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
,
Arvind Kumar Tyagi
Department of Surgical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Anushree Vartak
Department of Surgical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Pramod Solanki
Department of Pathology, Army Hospital Research and Referral, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Transitional cell carcinomas (TCCs) of lacrimal sac are extremely uncommon neoplasms with high degree of invasiveness, local recurrence, and distant metastasis despite an aggressive treatment. They generally present with epiphora and lacrimal mass lesion but rarely dacryohemorrhea or bloody tears. We hereby report a 50-year-old female who presented with complaints of epiphora, blood in tears, and a progressive swelling measuring 8 cm × 5 cm over left lacrimal sac site. Biopsy from the swelling revealed TCC of lacrimal sac. Radiographic imaging showed a localized mass lesion lacrimal sac eroding adjacent structures, left orbital extension, and left cervical lymphadenopathy without any intracranial extension or distant metastasis. She underwent wide local excision of the primary lesion with left orbital exenteration, left partial maxillectomy, left anterior ethmoidectomy, and left forehead flap reconstruction followed by adjuvant conformal radiotherapy to local site to a dose of 60 Gy and ipsilateral neck to 50 Gy. Combined modality therapy showed satisfactory cosmesis and overall improved functionality on her first review at 6 weeks, however she lost to further follow-up. A thorough review of literature reveals that our case may be one of the largest TCC of lacrimal sac ever reported and the third case to present with dacryohemorrhea in world literature till date.

Keywords

Dacryohemorrhea - exenteration - lacrimal sac - radiotherapy - transitional cell carcinoma


Publication History

Received: 18 August 2017

Accepted: 18 April 2018

Article published online:
03 June 2021

© 2019. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Azari AA, Kanavi MR, Saipe N, Lee V, Lucarelli M, Potter HD. et al. Transitional cell carcinoma of the lacrimal sac presenting with bloody tears. JAMA Ophthalmol 2013; 131: 689-90
    CrossrefPubMedGoogle Scholar
  • 2 Karim R, Ghabrial R, Lin B. Transitional cell carcinoma of the nasolacrimal sac. Clin Ophthalmol 2009; 3: 587-91
    CrossrefPubMedGoogle Scholar
  • 3 Preechawai P, Della Roccad RC, Della Rocca D, Schaefer S, McCormack S. Transitional cell carcinoma of the lacrimal sac. J Med Assoc Thai 2005; 88 Suppl 9 S138-42
    PubMedGoogle Scholar
  • 4 El-Sawy T, Frank SJ, Hanna E, Sniegowski M, Lai SY, Nasser QJ. et al. Multidisciplinary management of lacrimal sac/nasolacrimal duct carcinomas. Ophthal Plast Reconstr Surg 2013; 29: 454-7
    CrossrefPubMedGoogle Scholar
  • 5 Hornblass A, Jakobiec FA, Bosniak S, Flanagan J. The diagnosis and management of epithelial tumors of the lacrimal sac. Ophthalmology 1980; 87: 476-90
    CrossrefPubMedGoogle Scholar
  • 6 Harry J, Ashton N. The pathology of tumours of the lacrimal sac. Trans Ophthalmol Soc U K 1969; 88: 19-35
    PubMedGoogle Scholar
  • 7 Vickers JL, Matherne RJ, Allison AW, Wilkerson MG, Tyring SK, Bartlett BL. et al. Transitional cell neoplasm of the nasolacrimal duct associated with human papillomavirus type 11. J Cutan Pathol 2010; 37: 793-6
    CrossrefPubMedGoogle Scholar
  • 8 Ryan SJ, Font RL. Primary epithelial neoplasms of the lacrimal sac. Am J Ophthalmol 1973; 76: 73-88
    CrossrefPubMedGoogle Scholar
  • 9 Ni C, D'Amico DJ, Fan CQ, Kuo PK. Tumors of the lacrimal sac: A clinicopathological analysis of 82 cases. Int Ophthalmol Clin 1982; 22: 121-40
    CrossrefPubMedGoogle Scholar
  • 10 Islam S, Thomas A, Eisenberg RL, Hoffman GR. Surgical management of transitional cell carcinoma of the lacrimal sac: Is it time for a new treatment algorithm?. J Plast Reconstr Aesthet Surg 2012; 65: e33-6
    CrossrefPubMedGoogle Scholar