首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (3): 415-417.

• 临床研究 • 上一篇    下一篇

泪囊恶性肿瘤的诊治

张旭乡1, 曲冬懿2, 曲秋懿3   

  1. 1. 首都医科大学宣武医院眼科;2. 解放军总医院眼科;3. 首都医科大学宣武医院耳鼻咽喉-头颈外科
  • 收稿日期:2006-07-13 修回日期:1900-01-01 出版日期:2007-06-24 发布日期:2007-06-24

Diagnosis and Treatment of Malignant Tumor of Lacrimal Sac Tumor

Zhang Xuxiang1, Qu Dongyi2, Qu Qiuyi3   

  1. 1. Department of Ophthalmology, Xuanwu Hospital, Capital Medical University;2. Department of Ophthalmology, PLA GeneralHospital;3. Department of Otorhinolaryngology, Head and Neck Surgery, Xuanwu Hospital, Capital Medical University
  • Received:2006-07-13 Revised:1900-01-01 Online:2007-06-24 Published:2007-06-24

摘要: 目的 总结泪囊恶性肿瘤的诊断与治疗方法。方法 回顾性分析5例泪囊恶性肿瘤的临床表现、影像学检查、病理学检查及治疗等临床资料。结果 泪囊恶性肿瘤临床表现为:内眦肿物及不同程度溢泪、血性溢泪。经CT检查3例,泪囊钡剂造影、B超、MRI检查各1例。5例中有1例累及筛窦。经手术治疗或联合放射疗法,1例复发再次行鼻侧切开、上颌骨内侧部分切除术;其余4例无复发。病理学检查结果:鳞状上皮细胞癌2例,乳头状移行细胞癌、基底细胞癌和未分化癌各1例。结论 泪囊恶性肿瘤的早期表现为血性溢泪、内眦韧带以上的实性肿块,易误诊为泪囊炎。对于累及筛窦者,根据病史特点和影像学检查结果,可与原发筛窦癌鉴别。治疗应完整切除肿瘤,必要时术后辅以放射疗法。

关键词: 泪囊, 恶性肿瘤, 诊断, 治疗

Abstract: Objective To report a series of 5 primary lacrimal sac tumors and present an algorithm in managing this rare condition.Methods A retrospective review of the clinical,radiological,and pathological records of 5 patients with primary lacrimal sac tumors was conducted.Results Of the five patients,all had epiphora or mass above the medial canthal tendon.Four had bloody epiphora.Three cases of computerized tomography,one case of dacryocystography,B ultrasonic as well magnetic resonance.There was extension into the anterior ethomoid air cells in only one case.The commonest tumor was squamous cell carcinoma(two cases),followed by one case of transitional cell carcinoma,basal cell carcinoma,undifferentiated carcinoma.Treatment modalities included surgery,radiotherapy,one patient had a relapse,En bloc resection was performed using a lateral rhinotomy,medial maxillectomy.but four patients remained without evidence of recurrent tumor.Conclusion Bloody epiphora,chronic dacryocystitis that irrigates freely and mass above the medial canthal tendon are main signs of malignant lacrimal sac tumor.Early diagnosis with malignant lacrimal sac tumor is possible combining with adjunctive examination and biopsy specimen.It can be distinguished with ethomoid carcinoma combining with clinical performance and dacryocystography,computerized tomography as well magnetic resonance.The treatment of malignant lacrimal sac tumors is en bloc resection and postoperative irradiation.

Key words: lacrimal sac tumor, malignant tumor, diagnosis, treatment

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