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The pitfall of dacryostenosis
1Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel.
Ophthalmic Surgery
|April 1, 1992
Summary
Epiphora in elderly patients may indicate underlying paranasal sinus tumors, not just dacryostenosis. Early consideration of tumors is crucial before treatment.
Area of Science:
- Ophthalmology
- Otorhinolaryngology (ENT)
- Oncology
Background:
- Epiphora, or excessive tearing, is a common complaint in elderly patients.
- Dacryostenosis, a blockage of the tear drainage system, is a frequent diagnosis for epiphora.
- Surgical intervention like dacryocystorhinostomy is often considered for dacryostenosis.
Observation:
- A 65-year-old woman presented with epiphora, initially diagnosed as dacryostenosis.
- Following dacryocystorhinostomy, a large mass was discovered protruding from the incision site.
- Histopathological examination revealed the mass to be anaplastic carcinoma.
Findings:
- Computed tomography (CT) scan demonstrated extensive tumor filling the right-side paranasal sinuses.
- The patient's epiphora was ultimately attributed to a previously undiagnosed paranasal sinus tumor.
- Anaplastic carcinoma was identified as the specific type of malignancy.
Implications:
- Paranasal sinus tumors should be considered in the differential diagnosis of epiphora in the elderly population.
- Pre-treatment evaluation for epiphora should include consideration of potential malignancy.
- This case highlights the importance of thorough investigation before assuming benign causes for common symptoms in older adults.