Summary
The purpose of this study was to present the imaging features of primary and secondary malignant lacrimal sac and nasolacrimal duct tumors and their pattern of tumor spread in 18 patients. The most common tumor histology in our series was squamous cell carcinoma. In 15/18 patients, tumor involved both the lacrimal sac and duct at the time of diagnosis. In 11/16 patients on CT, the nasolacrimal bony canal was smoothly expanded without erosive changes. The medial canthus region (16/18) was a frequent site of direct tumor spread. Two patients had intraconal orbital spread of tumor. Tumor spread to the sinus or nasal cavity was observed in 5/13 primary tumors. Only 1 patient presented with nodal metastasis. There was no intracranial tumor extension, perineural tumor spread along the infraorbital nerve, distant metastasis, or dacryocystocele formation in any of the patients at the time of diagnosis.
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Fellows’ Journal Club
This case series presents 18 patients with primary and secondary malignant lacrimal sac and nasolacrimal duct tumors and their pattern of tumor spread. Squamous cell carcinoma was the most common histology and, in 15/18 patients tumor involved both the lacrimal sac and duct at the time of diagnosis. In 11/16 patients on CT, the nasolacrimal bony canal was smoothly expanded without erosive changes. Tumor was not observed solely within the nasolacrimal duct in any patient. Only 1 patient presented with nodal metastasis and there was no intracranial tumor extension or perineural tumor spread. The authors conclude that malignant lacrimal sac and nasolacrimal duct tumors tend to expand the nasolacrimal bony canal, rather than erode it. CT was superior to MR imaging in characterizing expansion versus erosion of the nasolacrimal bony canal.