Management with Radical Excision in Squamous Cell Carcinoma of the Lacrimal Sac

ABSTRACT

PURPOSE: Squamous cell carcinoma of the lacrimal sac is rare and there is high rate of recurrence after dacryocystectomy. We report successful radical excision of the tumor for the purpose of reducing the recurrence and improving the survival rate. METHODS: A 48-year-old man who had a history of epiphora and medial canthal mass for one year was referred to our clinic. CT scan showed a mass on the lacrimal fossa but there was no evidence of bony destruction or local invasion. We confirmed that the excised mass was squamous cell carcinoma of the lacrimal sac by frozen section. So, radical excision including bony and mucous nasolacrimal duct (NLD), inferior turbinate, and medial maxilla was performed through lateral rhinotomy. RESULTS: Ten months later, there was skin defect and medial canthal deformity. So we corrected the deformity with a forehead free flap and the result was cosmetically acceptable. There was no evidence of recurrence or distant metastasis for one- year follow- up period. CONCLUSIONS: Despite its high recurrence rate, we can reduce the recurrence and mortality rate of squamous cell carcinoma of the lacrimal sac with radical excision including bony and mucous NLD, inferior turbinate, and medial maxilla.