[Clinical and pathological analysis of primary lacrimal sac tumors]

To investigate the clinical features and pathological classification of primary lacrimal sac tumors.

A retrospective study of 96 cases of primary lacrimal sac tumors in past 50 years from EENT Hospital (Jan. 1956 to Dec. 2005) was performed to investigate the clinical features, radiological manifestation, histopathological classification and treatment.

Primary lacrimal sac tumors were more common in men than in women (1.8:1.0) and the median age at presentation was 46 years (ranged 11 - 80 years). The most common sign and symptom were epiphora and lacrimal sac mass, respectively. Among these primary lacrimal sac tumors, 94.8% were malignant tumors (91/95). All epithelial lacrimal sac tumors (83 cases, 86.5%) were malignant and squamous cell carcinoma was the most common tumor (64 cases, 66.7%), followed by undifferentiated carcinoma (10 cases, 10.4%), mucoepidermoid carcinoma (4 cases, 4.2%), adenocarcinoma (4 cases, 4.2%) and transitional cell carcinoma (1 case, 1.0%). The nonepithelial tumors consisted of mucosa-associated lymphoid tissue (MALT) lymphoma (5 cases, 5.2%), melanoma (3 cases, 3.1%), neurilemoma (2 cases, 2.1%), hemangiopericytoma (2 cases, 2.1%) and cavernous hemangioma (1 case, 1.0%).

Primary lacrimal sac tumors are extremely rare, but most of them are malignant tumors and are often misdiagnosed as dacryocystitis and lacrimal sac obstruction. Therefore, ophthalmologists should pay more attention to the diagnosis of lacrimal sac tumors.