A 7-year prospective study of routine histopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy in adults and a review of the literature

Knežević, Miloš; Stojković, Marija Mostarica; Jovanović, Milan; Stanković, Z.; Rašić, Dejan

doi:10.1007/s12032-010-9810-y

Cited by 16 publications

(31 citation statements)

References 29 publications

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“…In the current study, the large majority of patients who underwent endoscopic DCR were found to have either inflamed or normal‐appearing sac mucosa, consistent with other reported findings of DCR surgery . The unsuspected neoplasms and granulomatous pathology rate in our series was 0.46% (n = 3), compared with 0% to 2.3% reported in the literature . The clinical experience of the senior surgeon in this study may account for this relatively low rate.…”

Section: Discussionsupporting

confidence: 90%

“…A total of 17 specimens (4.5%) were neoplasms, with eight (2.1%) unsuspected prior to surgery. In 2012, a prospective series of 599 patients undergoing external DCR found eight neoplastic specimens (1.34%), six of which were without clinical signs, symptoms, or intraoperative appearance suggestive of a possible underlying lacrimal sac tumor . In 2018, Rauter et al performed a retrospective review of 218 DCR patients and reported five neoplasms (2.3%), all of which were unsuspected.…”

Section: Discussionmentioning

confidence: 54%

“…2,3,6,7,[13][14][15] The unsuspected neoplasms and granulomatous pathology rate in our series was 0.46% (n = 3), compared with 0% to 2.3% reported in the literature. [2][3][4][5][6][7][8][9][10][11][14][15][16][17][18] The clinical experience of the senior surgeon in this study may account for this relatively low rate. In all three unanticipated cases, the patient history, endoscopic examination, CT imaging, and intraoperative findings were not suggestive of neoplastic or granulomatous inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…In 2012, a prospective series of 599 patients undergoing external DCR found eight neoplastic specimens (1.34%), six of which were without clinical signs, symptoms, or intraoperative appearance suggestive of a possible underlying lacrimal sac tumor. 5 In 2018, Rauter et al performed a retrospective review of 218 DCR patients and reported five neoplasms (2.3%), all of which were unsuspected. Despite the relatively low incidence of neoplasm in these series, these findings do appear to support routine biopsy of the lacrimal sac at the time of DCR.…”

Section: Discussionmentioning

confidence: 99%

“…The current literature on the role of routine histopathologic sampling of the lacrimal sac during DCR is controversial. Some publications recommend routine lacrimal sac biopsy, [1][2][3][4][5] whereas others advocate biopsy only in select cases. [6][7][8][9][10][11] The purpose of this study was to examine the impact of routine biopsy of the lacrimal sac as performed during a consecutive series of endoscopic DCRs over the past 30 years.…”

Section: Introductionmentioning

confidence: 99%

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The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

et al. 2019

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Objectives/Hypothesis Most patients who undergo endoscopic dacryocystorhinostomy (DCR) have a diagnosis of idiopathic nasolacrimal duct obstruction. The purpose of this study was to examine the impact of routine biopsy of the lacrimal sac performed at time of DCR on subsequent patient diagnosis and treatment. Study Design Retrospective review. Methods The histopathology of nasolacrimal specimens (n = 769), obtained from 654 consecutive patients undergoing endoscopic DCR by a single surgeon over a 30‐year period, were reviewed. Specific focus included the identification of unanticipated pathologic findings as they related to pertinent patient demographics, clinical presentation, radiologic findings, and intraoperative observations. Results The study population was 69.6% female, with an average age of 56.1 ± 18.2 years. Pathological findings of tissue from the nasolacrimal sac, which was routinely sampled in all cases, showed inflammation (n = 566 [73.6%]), normal histology (n = 147 [19.1%]), granulomas (n = 8 [1.0%]), and neoplastic process (n = 7 [0.9%]). Patient history, preoperative CT scan, and/or intraoperative findings alerted the surgeon to the possibility of an unusual diagnosis in 12 of the 15 patients. An unsuspected neoplastic or granulomatous cause of lacrimal obstruction was identified on intraoperative biopsy in three patients (0.46%). Conclusions Although neoplastic and granulomatous diseases are relatively rare causes of lacrimal obstruction necessitating DCR surgery, they may be identified by through patient evaluation in most cases and by routine intraoperative biopsy of the lacrimal sac in all cases. Level of Evidence 4 Laryngoscope, 130:584–589, 2020

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

et al. 2019

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Effectiveness of Nasolacrimal SCC Treatments and Promising Role of Chemo‐Induction: A Case Report and Systematic Review

Alsavaf,

Abouammo,

Bhuskute

et al. 2024

The Laryngoscope

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ObjectiveTo comprehensively analyze reported cases of nasolacrimal squamous cell carcinoma (NLSCC), focusing on risk factors, treatment modalities, and outcomes. Additionally, investigate the impact of human Papillomavirus (HPV) status and histopathological subtypes' impact on prognosis.Data SourcesPubmed, Embase.Review MethodsWe conducted a systematic literature review to identify relevant studies reporting cases of NLSCC. The review methods adhered to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The final update was performed on May 31, 2023.ResultsThe 72 studies included a total of 313 participants (mean age: 55; 60% male). Longer symptom duration (44.1 ± 59.2 months) correlated with recurrence (p = 0.004), and males exhibited higher mortality rates (19.6% vs. 2.4% in females, p = 0.01). The overall survival (OS) rate among all patients was 87.1%. Basaloid NLSCC had a worse death outcome (p ≤ 0.001). HPV‐positive cases showed comparable OS, recurrence, and metastasis rates to the general population (p = 0.917, 0.851, 0.07, respectively). Comparing treatment approaches (surgery, surgery with adjuvant radiation, chemoradiotherapy [CRT] followed by surgery), no significant differences in 5 and 10‐year OS rates or recurrence were observed (p = 0.4, 0.24, respectively), but 5‐year metastasis events were significant (p = 0.024). Eye exenteration rates were 31.1%, 20%, and 0% for the respective treatments (p = 0.089). Induction chemotherapy saved four cases from potential exenteration with favorable prognosis.ConclusionEarly detection and diagnosis are of utmost importance in the management of NLSCC. Regardless of the treatment approach, HPV‐related NLSCC demonstrated similar outcomes to the general population. Basaloid histology represents the worst subtype in terms of prognosis. Limited adjuvant CRT cases showed improved outcomes and induction chemotherapy's importance was emphasized in recent literature and our shared experience. Laryngoscope, 2024

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The predictive value of nasolacrimal sac biopsy in endoscopic dacryocystorhinostomy

Eldsoky

Ismaiel

Hasan

et al. 2021

Annals of Medicine &Amp; Surgery

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Background During dacryocystorhinostomy (DCR), the lacrimal sac wall biopsy is not routinely performed in our hospital, but it is recommended if there is a suspicion of underlying disease other than preoperatively or intraoperatively chronic inflammation. Objective Most of patients with epiphora have different causes of nasolacrimal duct obstruction (NLDO). This study aims to examine how important routine lacrimal sac biopsy is during endoscopic DCR surgery. Patients & methods The study included 50 patients with chronic unilateral epiphora. All patients underwent endoscopic DCR with NLD biopsy. Histopathologic analysis was performed for each specimen. Results The findings of NLD biopsy showed chronic inflammation in 33 cases (66%), chronic dacryocystitis in 9 cases (18%), dacryolith with dacryocystitis in one case, granuloma in 4 cases (8%), rhinoscleroma in 2 cases (4%), and one case had a neoplasm. Histopathologic findings were inflammatory cellular infiltrates in 56%, 30% and 14% in mild, moderate and severe chronic inflammatory state (CIS) score, respectively. Fibrosis in 18%, 20% and 62% in mild, moderate and severe CIS score, respectively. Capillary proliferation in 64%, 32% and 4% in mild, moderate and severe CIS score, respectively. Chronic inflammatory signs in 64%, 32% and 4% in mild, moderate and severe CIS score, respectively. Conclusion Although neoplasm and granuloma are rare cause of lacrimal sac or duct obstruction requiring DCR, they were detected through nasolacrimal assessment and routine intraoperative lacrimal sac biopsy.

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A 7-year prospective study of routine histopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy in adults and a review of the literature

Cited by 16 publications

References 29 publications

The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

Effectiveness of Nasolacrimal SCC Treatments and Promising Role of Chemo‐Induction: A Case Report and Systematic Review

The predictive value of nasolacrimal sac biopsy in endoscopic dacryocystorhinostomy

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