CT and MRI findings in relapsing primary malignant melanoma of the lacrimal sac: a case report and brief literature review

Shao, Ju-Wei; Yin, Jianhua; Xiang, Shutian; He, Qian; Zhou, Hong; Su, Wei

doi:10.1186/s12886-020-01356-6

Cited by 10 publications

(14 citation statements)

References 24 publications

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“…Imaging is essential for identifying the location, size, and extent of the lesion; assessing the disease severity; and differentiating tumors from inflammatory and infectious lesions [53]. CT scans of the orbit or paranasal sinuses with axial, coronal, or sagittal images are used to diagnose lacrimal sac tumors, and to assess osteolytic changes and the invaded surrounding tissues [2, 4-6, 12-14, 27, 32-35, 53]. A benign lesion is typically defined as a well-defined lesion without any bone erosion on CT images.…”

Section: Discussionmentioning

confidence: 99%

Lacrimal Sac Tumors: A Case Series

Kadir¹,

Rashid²,

Sultana³

et al. 2021

Ocul Oncol Pathol

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Objective: The aim of the study was to describe the clinical presentation, management strategies, and outcomes in a case series of primary lacrimal sac tumors. Methods: This retrospective study was conducted in Sheikh Fajilatunnessa Mujib Eye Hospital and Training Institute, Bangladesh, from July 1 to December 31, 2020, and included all patients who were evaluated, treated, and followed up for at least 6 months from January 2013 to October 2020. One patient developed a recurrence of the adenocarcinoma of the lacrimal sac after 1 year of primary treatment. Patients’ demographic data were analyzed and reviewed from published articles on lacrimal sac tumors. We assessed patients clinically, followed by radiological evaluation. We also analyzed the biopsy technique, treatment modality, and recurrence. An oncologist reviewed all patients to prepare a plan for adjuvant treatment. Results: Ten patients with lacrimal sac tumors were included in this study. Swelling in the medial canthal region was the most common presenting feature (100%), followed by epiphora (60%) and pain (30%). Open biopsy was preferred over fine-needle aspiration biopsy. Incisional biopsy or complete excisional biopsy was performed for all suspected malignancies. Malignant tumors were found in 7 (70%) cases, and benign tumors in 3 (30%) cases. Non-Hodgkin’s lymphoma (NHL) (40%) was the most common malignant lacrimal sac tumor. Mucosa-associated lymphoid tissue lymphoma was 75%, and diffuse large B-cell lymphoma was 25% among the cases of NHL. Patients with epithelial malignancy were treated with external beam radiation therapy, while NHL patients were treated with chemotherapy (CHOP regimen). Recurrence was noted in 1 case (10%) of epithelial malignancy after 1 year of treatment. Conclusion: Successful management of lacrimal sac tumors requires a high index of suspicion, as these are fatal tumors, often misdiagnosed as dacryocystitis. Nonepithelial malignancies are more predominant than epithelial malignancies, and hematolymphoid tumors are most frequent.

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Section: Discussionmentioning

confidence: 99%

Lacrimal Sac Tumors: A Case Series

Kadir¹,

Rashid²,

Sultana³

et al. 2021

Ocul Oncol Pathol

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“…As a consequence, a total of 30 publications describing 38 cases were examined in the present work, 5,9‐37 as listed in Figure 1. Twenty‐three papers were single case reports, 5,9‐12,14,15,17‐20,22‐25,27‐29,33‐37 three papers were case series reporting only lacrimal melanomas, 13,21,30 and four were case series on lacrimal tumors including at least one LDSM 16,26,31,32 . The sample included 15 males and 19 females (in four cases sex was not specified), with a mean age of 61 years (range 41–80).…”

Section: Resultsmentioning

confidence: 99%

“…For 34 patients follow-up was reported 5,9,10,[12][13][14][15][16][17][18][19][20][21][22][24][25][26][27][28][29]31,[33][34][35][36][37] : among these, 11 were recurrence-free after a mean duration of 18 months, 5,10,15,17,19,21,25,26,29,31,36 while 23 patients experienced loco-regional or distant relapse. 9,[12][13][14]16,18,20,22,24,27,28,[33][34][35] The abovementioned data are summarized in Table…”

Section: Follow-up and Outcomesmentioning

confidence: 99%

Melanoma of the lacrimal drainage system: A systematic review

et al. 2021

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Melanoma of the lacrimal drainage system (LDSM) is a rare and subtle condition that is frequently misdiagnosed. In the present work, we conducted a systematic review investigating the clinical features, management, and prognosis of LDSM. A structured search, according to PRISMA criteria, was performed in April 2020 and updated in February 2021 on Pubmed, EMBASE, Cochrane, and SCOPUS. The articles found underwent a double‐reviewer selection and the main data were extracted. After complete screening, 30 articles reporting 38 cases were included. The time from the first symptom to medical contact ranged from 1 month to 4 years. Surgery was the treatment proposed to all patients, with a variable extension of resection. LDSM is a rare disease that is burdened by poor prognosis. Early diagnosis is crucial, even if difficult to achieve. Surgery and radiotherapy are standardized treatments, while targeted therapy and immunotherapy are attractive prospects.

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“…Tearing with blood reflux and a mass above the medial canthal tendon should alert clinicians of lacrimal sac malignancy [31]. The low index of suspicion and diagnostic delay contribute to the spread of the tumor through vascular and nasolacrimal routes with adjacent orbital structures with poor survival outcomes [32,33]. Almost all patients developing metastasis died (Table 3), which may be attributed to the current limitations of effective systemic therapy for metastasis disease.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Clinical Feature and Treatment Outcome of Ocular Melanoma: A 34-Year Experience in a Tertiary Referral Center

Huang

Hou

et al. 2021

Cancers

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Malignant melanoma can arise from melanocytes in various structures of the eye, orbit, and ocular adnexa. We reviewed the clinical features and long-term results of all subjects with histologically proved melanoma originating from any of the ocular and periocular structures in a tertiary referral center. Overall, 88 patients including 47 men were recruited. The tumor was primarily located in the uvea, followed by the conjunctiva, orbit, eyelid, and lacrimal sac. Patients with uveal melanoma were diagnosed at a relatively younger age (47.0 years), while those with orbital and eyelid melanomas were older at presentation (79.5 years and 78.5 years, respectively). The overall local recurrence rate was 9% at a median follow-up of 41.0 months, among which orbital and eyelid melanomas recurred most commonly. The overall mortality rate was 41% in a median duration of 27.2 months (IQR, 13–58 months) from diagnosis, with the highest for lacrimal sac melanoma, followed by melanoma of the orbit, uveal, conjunctiva, and eyelid. Despite prompt local control, the risk for metastasis and mortality was high. Therefore, efficient modalities for early diagnosis and treatment of ocular melanoma are necessary.

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CT and MRI findings in relapsing primary malignant melanoma of the lacrimal sac: a case report and brief literature review

Cited by 10 publications

References 24 publications

Lacrimal Sac Tumors: A Case Series

Lacrimal Sac Tumors: A Case Series

Melanoma of the lacrimal drainage system: A systematic review

The Clinical Feature and Treatment Outcome of Ocular Melanoma: A 34-Year Experience in a Tertiary Referral Center

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