Lacrimal Sac Tumors: Diagnosis and Treatment

  • H. Jane KimEmail author
  • Carol L. Shields
  • Paul D. Langer


Lacrimal sac tumors are uncommon, but noteworthy as they are frequently locally invasive and can result in death. Approximately 750 cases have been reported in the literature over the last century, of which approximately 50–100% were malignant [1–14]. The benign tumors include squamous papilloma, transitional papilloma, fibrous histiocytoma, oncocytoma, and hemangiopericytoma. The malignant tumors include squamous cell carcinoma, lymphoma, melanoma, transitional carcinoma, mucoepidermoid carcinoma, and adenocarcinoma, in order of frequency. The most serious malignancies of the lacrimal sac are malignant melanoma and transitional cell carcinoma where the latter is associated with a 100% mortality rate [2]. The recurrence rate can be particularly high for some lacrimal sac malignancies as they can be invasive, multifocal, and located in vital nasopharyngeal regions. For example, the recurrence rate for invasive squamous and transitional cell carcinoma is approximately 50%, with 50% of those being fatal [1, 15]. Clinically, lacrimal sac tumors commonly masquerade as chronic dacryocystitis and often are unknowingly monitored conservatively until far advanced. Therefore, a high index of suspicion, awareness of the clinical presentation, and judicious examination of the lacrimal sac with imaging preoperatively and inspection at the time of surgery are necessary to confirm the diagnosis and to provide proper management.


Chronic Lymphocytic Leukemia Transitional Cell Carcinoma Adenoid Cystic Carcinoma Fibrous Histiocytoma Mucoepidermoid Carcinoma 
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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • H. Jane Kim
    • 1
    Email author
  • Carol L. Shields
    • 1
  • Paul D. Langer
    • 2
  1. 1.Department of Ocular Oncology Service, Wills Eye InstituteThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.New Jersey Medical SchoolNewarkUSA

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