A Mass of the Right Lacrimal Sac in a 53-Year-Old Man

Document Type

Article

Publication Date

11-1-2005

Description

Transitional cell carcinoma of the lacrimal sac is the second most common type of lacrimal malignancy; it is potentially lethal if it is not recognized and treated. The tumor in the patient presented here was composed microscopically of a combination of exophytic and endophylic (inverted) papillary lesions. Spindly, elongated cells with goblet cells were found, with areas of increased cellularity, nuclear pleomorphism, and mitotic figures, which was suggestive of a diagnosis of transitional cell carcinoma rather than benign papilloma. This distinction is important, as the former may require the addition of radiation therapy in the treatment protocol because of its poor prognosis, difficulty in achieving complete excision, and high rates of recurrence. In this patient, additional tumor was found on imaging studies and the residual tumor was excised with subsequent radiation therapy.

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