Solís AL, Rojas RI, Vigoa AL, González PB

Language: Spanish
References: 12
Page: 1-8
PDF size: 269.31 Kb.

ABSTRACT

Lacrimal sac tumors are extremely rare, and the most common benign primary is squamous papilloma. Clinically, they manifest as a zone of swelling in the medial canthal region, associated with epiphora and chronic-recurrent dacryocystitis. Among the recommended imaging tests are dacryostography, computed tomography, magnetic resonance imaging, and dacryoscintifotography. However, very few suggest the use of ultrasound. The case of a mixed papilloma of the lacrimal sac diagnosed by ultrasound is presented. This is a 39-year-old female patient, who was referred for repeated cases of right dacryocystitis in the last three years. In consultation, ipsolateral preseptal cellulitis was found, for which antibiotic therapy was indicated, and the remission of acute inflammatory signs was achieved, but the increase in right medial canthal volume persisted. The lacrimal duct was explored and found to be obstructed. Ultrasound was performed, where the right lacrimal sac appeared occupied by an echogenic mass, which extended to the lacrimal duct and showed slight vascularity. Subsequently, computed tomography was performed, and the ultrasound findings were confirmed, but without defining the described intrasaccal lesion, even after administration of intravenous iodinated contrast. It was suggested chronic right dacryocystitis, secondary to apparently benign intrasaccal tumor, probable papilloma, so surgery and histopathological examination were performed, which that ratified the diagnosis. In conclusion, ultrasound of the lacrimal sac is a complementary method of great value, which in some cases will make the diagnosis, while in others it will provide information that will optimize the decision of those who would be candidate to more complex studies.

REFERENCES

1. Coloma-González I, Flores-Preciado J, Ceriotto A, Corredor-Casas S, Salcedo-Casillas G. Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in Mexican patients 2007-2012. Arch Soc Esp Oftalmol. 2014;89(6):222-5.

2. Tarjani Vivek D, Dilip M, Ruchi M, Mohammad Javed A. Accidentally diagnosed transitional cell papilloma of the lacrimal sac. Saudi J Ophthalmol. 2017;31(3):177-9.

3. Lefebvre F. Update on Imaging of the Lacrimal Drainage System. Semin Ophthalmol. 2012;27(5-6):175-86.

4. Jong-Suk L, Hwa L, Minwook Ch, Minsoo P, Sehyun B. Benign mixed tumor of the lacrimal sac. Indian J Ophthalmol. 2015;63(3):282-4.

5. Campos Machado MA, Ferrari Silva JA, Alonso Garcia E, Allemann N. Ultrasound parameters of normal lacrimal sac and chronic dacryocystitis. Arq Bras Oftalmol. 2017;80(3):172-5.

6. Byungjin K, Hwaejoon J, Jae-Min Sh, Il-Ho P, Heung-Man L. Clinical characteristics of lacrimal sac tumors: Report of Ten Cases. J Rhinol. 2017;24(1):14-9.

7. Kumar VA, Esmaeli B, Ahmed S, Gogia B, Debnam JM, Ginsberg LE. Imaging Features of Malignant Lacrimal Sac and Nasolacrimal Duct Tumors. AJNR 2016;37(11):2134-7.

8. Kemeny-Beke A, Szabados L, Barna S, Varga J, Galuska L, Kettesy B, et all. Simultaneous dacryocystography and dacryoscintigraphy using SPECT/CT in the diagnosis of nasolacrimal duct obstruction. Clin Nucl Med. 2012;37(6):609-10.

9. Parmar DN, Rose GE. Management of lacrimal sac tumours. Eye 2003;17(5):599-606.

10. Song X, Wang J, Wang S, Wang W, Wang S, Zhu W. Clinical analysis of 90 cases of malignant lacrimal sac tumor. Graefes Arch Clin Exp Ophthalmol. 2018;256(7):1333-8.

11. Velasco A, Levy A, Cortés Durand I, Martínez Mayorquín VC, Delgado Sotelo R, Cerda Camacho F. Carcinoma de células transicionales de saco lagrimal. Rev Mex Oftalmol. 2016;90(6):309-13.

12. Tao H, Liu X, Mei X, Han C, Wang P, Bai F. Ultrasonic 3D reconstruction and measurement of lacrimal sac in normal adult chinese population. Int J Morphol. 2016;34(4):1357-61.