Surgical management of transitional cell carcinoma of the lacrimal sac: Is it time for a new treatment algorithm?

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 65; no. 2; pp. e33 - e36
• Main Authors: Islam, Shofiq, Thomas, Alexandria, Eisenberg, Robert L., Hoffman, Gary R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2012
• Subjects: Adult; Algorithms; Carcinoma; Carcinoma, Transitional Cell - diagnosis; Carcinoma, Transitional Cell - surgery; Eye Neoplasms - diagnosis; Eye Neoplasms - surgery; Follow-Up Studies; Forearm - surgery; Free Tissue Flaps; Humans; Lacrimal Apparatus; Lacrimal sac; Male; Maxilla - surgery; Neck dissection; Neck Dissection - methods; Ophthalmologic Surgical Procedures - methods; Orbital exenteration; Parotidectomy; Plastic Surgery; Recurrence; Surgical managment; Tomography, X-Ray Computed; Transitional cell carcinoma; Treatment; Recurrence; Carcinoma; Treatment; Surgical managment; Lacrimal sac; Parotidectomy; Orbital exenteration; Transitional cell carcinoma; Neck dissection
• ISSN: 1748-6815; 1878-0539; 1878-0539
• DOI: 10.1016/j.bjps.2011.09.029

Transitional cell carcinoma (TCC) arising in the lacrimal sac is a rare neoplasm. Despite radical surgery and radiotherapy, these tumors generally have a poor prognosis due to an often late diagnosis, high rate of loco-regional recurrence and mortality. There are only a relatively small number of documented cases of TCC when compared to other epithelial malignancies of the lacrimal drainage system. As would be anticipated, there are currently no evidence-based clinical practice guidelines for the treatment of these lesions. We present an illustrative case and consider the literature in relation to current surgical management of these tumors. We propose an alternate management consideration for these tumors.