Nonepithelial tumors of the lacrimal sac

Lacrimal sac tumors are rare and mostly of epithelial origin. We conducted a clinicopathologic study of 35 cases of nonepithelial tumors of the lacrimal sac. These tumors included 13 fibrous histiocytomas, one hemangiopericytoma, one lipoma, ten lymphoid lesions, eight malignant melanomas, one granulocytic sarcoma, and one neurofibroma. Except for one 9-year-old child with fibrous histiocytoma, all neoplasms involved adults (age range, 27 to 90 years). The most common initial signs and symptoms were epiphora, chronic inflammation, or lacrimal mass. A bloody nasal discharge and bleeding from the punctum occurred in a patient with malignant melanoma. In none of the patients was the clinical diagnosis of a lacrimal sac tumor made preoperatively. Some of the nonepithelial neoplasms of the lacrimal sac can be life-threatening; therefore, early diagnosis and treatment are important.