[Carcinoma of the lacrimal sac: a clinicopathologic case study]

A case of undifferentiated carcinoma of the right lacrimal sac is reported in an 85-year-old woman who had already presented three previous carcinomas (uterine cervix, rectum, and breast). After a 1-year history of chronic dacryocystitis, she was admitted in January 2008 because of a painful and inflammatory swelling in the medial right lower eyelid. Imaging techniques showed an infiltrative mass in the lacrimal sac area and surgical biopsy disclosed undifferentiated carcinoma. The patient underwent orbital exenteration and the histopathological study confirmed the diagnosis. During 6 months of follow-up, no local recurrence was detected, but a thoracic CT scan revealed a pulmonary nodule that was probably metastatic. Making an early diagnosis of a lacrimal sac tumor is difficult and it should be considered in the differential diagnosis of chronic dacryocystitis. In these cases, more extensive research with lacrimal sac biopsy should be conducted.