Transitional cell carcinoma of lacrimal sac

摘要: Primary lacrimal sac malignancies are uncommon lesions. A male patient, aged 83 years, presented with rapidly growing lesion near the medial canthus of the right eye (Fig. A). The lesion was first noticed by the patient 3 weeks back as mild fullness. This was associated with constant epiphora and a single episode of bloody epiphora. On examination, there was a firm mass in the lacrimal sac area with extension above the medial canthus (Fig. A). The skin over the lesion had restricted mobility. Irrigation was not patent and the probe showed a firm stop at the level of distal canaliculi. Endoscopic examination showed a highly vascular mass involving the nasolacrimal duct area in the inferior meatus (Fig. B). CT scans showed a large mass lesion arising from the lacrimal sac and traversing the entire lacrimal fossa and bony nasolacrimal duct into the inferior meatus (Fig. C). The left lacrimal system and both eyes ocular …