The predictive value of nasolacrimal sac biopsy in endoscopic dacryocystorhinostomy

Abstract

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.

Incidental finding of metastatic prostatic adenocarcinoma of frontotemporal bone presenting as subdual hematoma: A case report and review of literature

“…Cranial neurological deficits or nerve palsies caused by prostatic cancer metastasis are uncommon in advanced disease but constitute important clinical characteristics. Skull metastasis can cause symptoms of nervous system debilitation, such as cranial nerve palsy, preferentially causing urological symptoms, facial nerve palsy, multiple cranial nerve palsies, otological symptoms, and ophthalmoplegia [ [2] , [3] , [4] , 14 , 17 ].…”

“…Prostate cancer metastasis is frequently observed in the axial skeleton, and skull bone metastasis in prostatic adenocarcinoma (PCa) is extremely rare, accounting for less than 2% of all metastases. It often invades the base of the skull and has diverse clinical manifestations to preferentially cause urological symptoms or multiple cranial nerve palsies, otological symptoms, and ophthalmoplegia, especially bone pain or cranial deficits [ [1] , [2] , [3] , [4] , [5] ].…”

“…Previous reports have documented skull metastases from all types of primary cancers, the most common being breast, lung, prostate, and thyroid cancers [ 1 , 3 , 5 ]. As the treatment of patients with advanced bony tumors is more effective and the life expectancy is longer, an increasing number of imaging studies have found skull bone metastasis.…”

“…Most skull bone metastases are purely intraosseous lesions limited to the calvarium or base of the skull [ 6 ]. A review of previous reports and literature revealed that metastatic prostate cancer of the temporal bone is rare, especially in the frontotemporal bone [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ].…”

Outcome of the endoscopic repair of frontal sinus cerebrospinal fluid leak

“…Gâta et al [ 6 ] reported revision surgery rates that were low and carried out for minor complications in two patients. There are multiple reported postoperative complications of such endoscopic surgery included cerebral edema (increased ICT), anosmia, frontal lobe deficits, frontal lobe traction, intracerebral hemorrhage, prolonged hospital stay in addition to mucocele formation [ 1 , 20 , 21 ].…”