P63 Positive Mucoepidermoid Tumor of the Lacrimal Sac with Associated Papilloma

Iordanous, Yiannis; Belrose, Jillian C.; Cadieux, Dani C.; Chakrabarti, Subrata; Farmer, James; Allen, Larry H.

doi:10.3109/01676830.2015.1049370

Cited by 8 publications

(4 citation statements)

References 12 publications

(11 reference statements)

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“…Common benign epithelial neoplasms include squamous cell papilloma and transitional cell papilloma. Benign nonepithelial tumors are fibrous histiocytomas [23, 29-35, 37]. The others include epithelial oncocytoma and a benign mixed tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Open biopsy was the preferred biopsy technique rather than FNAB in this study. Incisional biopsy is helpful for suspicious lacrimal sac tumors [22, 36, 37, 42-44, 46, 47]. Immunohistochemical analysis is important to confirm malignant cases.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with premalignant and malignant tumors showed a decreased recurrence rate with lateral rhinostomy (12.5%) and wide excision compared to those without rhinostomy (43.7%) [16]. Recurrence and mortality rates for lacrimal sac tumors vary [37, 39, 41-52, 54-56]. Benign tumors of the lacrimal sac have a good prognosis if completely excised, but benign papillomas with inverted patterns tend to recur.…”

Section: Discussionmentioning

confidence: 99%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lacrimal Sac Tumors: A Case Series

Kadir¹,

Rashid²,

Sultana³

et al. 2021

Ocul Oncol Pathol

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“…[ 11 ] A previous publication demonstrated that mucoepidermoid carcinoma of lacrimal gland could be strongly stained with p63. [ 13 ] Based on the morphology of tumor tissue and clinical signs of patients, mucoepidermoid could be ruled out. CEPA is considered to be a type of carcinoma that exhibits histological features of benign pleomorphic adenoma.…”

Section: Discussionmentioning

confidence: 99%

Primary poorly differentiated lacrimal gland adenocarcinoma in left ocular region

Xia

Ling²,

Zhang³

et al. 2018

Medicine

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Rationale:Primary poorly differentiated lacrimal gland adenocarcinoma in the orbital region is an extremely rare type of neoplasm with only 1 related case in the literature. Its high grade of malignancy makes the timely data reported necessary. Hence, we present an extremely rare disease with biopsy results and recommendations on clinical treatment in an elderly male with Chinese descent.Patient concerns:A 66-year-old Chinese man presented with swelling in the left ocular region and eyeball proptosis. On physical examination, the patient had redness, tenderness, and swelling of the left eye. A surgical incision was noted on the left orbital region. Left eye movements were restricted.Diagnoses:Immunohistochemical examination revealed pan-cytokeratin (PCK, +), p63 (partial, +), cytokeratin 7 (CK7, +), cytokeratin 14 (CK14, +), epithelial membrane antigen (EMA, +), protein expressed by erythroblast transformation-specific related gene (ERG, −), S-100 (, −), Epstein–Barr virus-encoded small RNA (EBER, −), smooth muscle actin (SMA, −), and Ki-67 (with a proliferation index approximately 40%). After carefully reviewed the manifestations, imaging findings, and immunohistochemical evidences, a diagnosis of poorly differentiated adenocarcinoma of lacrimal gland was made.Intervention:Based on the gene sequencing results, we started the patient with an intensive PF chemotherapy including a combination of cisplatine, fluorouracil, and epirubicin. Two months later, radiotherapy was introduced to the therapy regimen.Outcomes:The patient responded well to the treatment without severe adverse events. MRI scan showed remarkable remission.Lessons:This rare case report will help raise the awareness of high grade lacrimal gland cancer, and subsequently aid the diagnosis in future cases. Positive immunohistochemical markers of CK7, CK14, EMA, p63, and high proliferation index of Ki-67 can help establishing a diagnosis, and cisplatine–fluorouracil program is proved feasible. We share the difficulties we have encountered, hoping to improve patient care in the future.

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