Combined External, Endoscopic, Endonasal-Assisted En Bloc Resection of Malignant Tumors From the Lacrimal Drainage System

Purpose: The aim of this study is to describe a minimally invasive technique of en bloc resection of malignant tumors from lacrimal drainage system (LDS). Methods: This was a noncomparative, retrospective chart review of the clinical and pathologic findings of patients presenting with a LDS malignant tumor who underwent endoscopic prelacrimal recess approach with a small external incision for en bloc excision of the LDS. Results: A total of 12 patients from April 2010 to July 2017 were reviewed in this study. Of the 12 patients, 7 were males. The mean age was 51 years (range, 38–66 years), and all cases were unilateral. Histopathology revealed 3 adenoid cystic carcinomas, 2 squamous cell carcinomas, 2 melanomas, and 1 each of papilloma with carcinoma, papillary squamous cell carcinoma, mucoepidermoid carcinoma, B-cell lymphoma, and natural killer/T-cell lymphoma. Epiphora and a mass were the most common presentations. Adjuvant radiotherapy was given in 6 cases after surgery. Eleven patients remain alive and mean disease-free survival time was 25 months (range, 3–78 months). Two cases with malignant melanoma showed recurrence and 1 patient died of metastatic involvement. Conclusion: Endoscopic endonasal approach combined with a small external incision is efficient method for the management of tumors arising from the LDS. Address correspondence and reprint requests to Wencan Wu, PhD, Eye Hospital at Wenzhou, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China; E-mail: wuwencan118@163.com Received 16 February, 2018 Accepted 9 April, 2018 This study was supported by the Natural Science Foundation of China (81371028), Natural Science Foundation of Zhejiang Province, China (LY12H12006), and the Guided Innovation Project of the Eye Hospital of Wenzhou Medical University (YNCX201104). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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