Clinical Characteristics of Lacrimal Sac Tumors: Report of Ten Cases

BACKGROUND AND OBJECTIVES: To review our experience with lacrimal sac tumors in an effort to identify features, to evaluate the results of various methods of management, and to compare our data with previous studies. METHODS: We reviewed the medical records of all patients with lacrimal sac tumors who were managed in our institution between January 1990 and December 2015. The pre-operative clinical data, imaging, operation notes, and follow-up records were reviewed for each patient. RESULTS: The study group consisted of four men and six women with a mean age of 47.6 years. Most patients experienced long-standing epiphora, for a mean period of 20 months. Two of the tumors were benign, and eight of them were malignant. The benign tumors were treated with dacryocystectomy. All but one malignant tumor were treated with medial or total maxillectomy. Adjuvant radiotherapy was administered to four patients with malignant tumors. In the eight patients with malignant tumors, the mean follow-up period was 65 months. CONCLUSIONS: Important characteristics of lacrimal sac tumors include dacryocystitis, epiphora, and in some cases, a palpable medial canthal area mass. Wide en bloc resection via medial or total maxillectomy and/or postoperative radiotherapy are proper treatments for malignant lesions of the lacrimal sac.

Pulsatile Tinnitus Related with Prominent Venous Plexus: Case Report and Literature Review / 대한이비인후과학회지

Pulsatile tinnitus coexists with patient's heartbeat and objective tinnitus is audible to other persons such as examiner. It can be disagreeable for the patient and can also be the only clue to a potentially devastating and life-threatening disease. Pulsatile tinnitus with a normal otoscopic examination often presents a diagnostic challenge, and its differential diagnosis includes a wide range of conditions. Evaluation of a patient with tinnitus requires a detailed history, a comprehensive audiological evaluation with hearing thresholds, neuro-otological physical examination with otoscopy and imaging studies. We recently experienced a case of a 28-year-old male complaining of right-sided pulsatile tinnitus. The tinnitus was objectively audible at the left side of the posterior neck. Non-contrast enhanced computed tomography of temporal bone showed a high jugular bulb on the left side. A 6-vessel angiography showed prominent left paravertebral venous plexus and prominent venous plexus around the skull base.

A Case of a Primary Branchiogenic Carcinoma with a Synchronous Tonsil Squamous Cell Carcinoma / 대한이비인후과학회지

Branchiogenic carcinoma (BC), which is defined as squamous cell carcinoma arising from a branchial cyst, was first described by Volkmann in 1882. This rare disease is regarded as hypothetical, and remains a controversial disease entity. Among the diagnostic criteria of BC, the key point is the histologic demonstration of a cancer developing from the wall of an epithelial-lined cyst in the lateral site of the neck. In previous literature, many authors argued that this malignancy is actually cystic metastasis from oropharyngeal squamous cell carcinoma. We report a case of a 49-year-old female who was diagnosed as a primary BC patient with a synchronous tonsillar squamous cell carcinoma. Although this case did not meet the traditional diagnostic criteria because of existing tonsil cancer, we could diagnose these diseases as primary malignancies, since the transition zone was clearly seen, and there was no lymph node component in the histopathologic examination.

A Case of Mucinous Cystadenoma Mimicking Mucoepidermoid Carcinoma in Parotid Gland / 대한이비인후과학회지

Cystadenoma rarely arises in the parotid gland. It grows slowly without pain. Histopathologically, it is subdivided into papillary cystadenoma and mucinous cystadenoma. Mucinous cystadenoma arising from the salivary gland is a very rare benign tumor. A 25-year-old female patient visited our hospital with a left infra-auricular mass. Computed tomography scan showed a 3.1x2.3 cm size heterogeneous lesion with an irregular margin in the left parotid gland. Sono guided gun biopsy was performed to reveal fibrous tissue with atypical epithelial cell with mucin. Suspecting mucoepidermoid carcinoma, partial parotidectomy was performed for treatment and diagnosis. Histopathologic exam revealed mucinous cystadenoma. Cystadenoma of salivary gland has no distinct clinical feature, and is difficult to differentiate clinically from other salivary gland tumors as well as its malignancy. Thus, the possibility of malignancy must be considered for differential diagnosis.