Lacrimal sac tumor

Introduction to lacrimal sac tumor Lacrimal sac tumors are rare, but there are many types, most of which are primary tumors, and can also be caused by invasion of the orbital, nasal and paranasal sinus tumors; very few are metastatic tumors, and the lacrimal sac metastatic tumors often infringe Its adjacent tissues, such as the face, paranasal sinus and so on. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: nosebleeds

Causes of lacrimal sac tumor

Causes:

The cause is not fully understood, and some of the lacrimal sac tumors are associated with chronic chronic lacrimal sac inflammation.

Pathogenesis:

The benign tumors of the lacrimal sac are relatively few, mainly including: lacrimal sac cyst, papilloma, pleomorphic adenoma, fibroid, myoblastoma, polyp, capillary hemangioma, benign melanoma (), etc. Cysts and papilloma are more common. After the nasolacrimal duct and the lacrimal duct are blocked or narrowed, the mucus secreted by the lacrimal mucosa itself cannot be discharged and gradually enlarged. The patient has no pain, and the papilloma Often occurring in long-term chronic dacryocystitis or mucosal trauma, the production of polyps in the lacrimal sac is often accompanied by nasal polyps or allergic nasal diseases. There are two types of lacrimal sac papilloma: one type protrudes into the cyst cavity and occupies the lumen. One type grows in the wall of the capsule (and there are two cases), and 40% of the latter find early malignant transformation.

Lacrimal sac tumor prevention

Pay attention to hygiene, be careful not to use excessive eyes, and ensure regular sleep checks.

Dacryocyst tumor complications Complications, nosebleed, eyeballs

There may be nosebleeds, eyeballs and other symptoms.

Symptoms of lacrimal sac tumors Common symptoms Cysts tears eyebrows bow cysts skin infiltration lacrimal duct obstruction

There are 3 signs of lacrimal sac tumor: the mass in the lacrimal sac area, the mass is located above the level of the medial malleolar ligament; the skin on the surface of the mass has telangiectasia, and the blood flow in the lacrimal duct is reversed. The patient may have tears or bloody tears flowing out. Ni Kuang et al studied 82 cases of lacrimal sac tumors, which were divided into 4 stages: stage I (early stage) without specific symptoms and signs, no cysts in the lacrimal sac area; stage II, obvious mass in the lacrimal sac area; stage III The tumor expands to adjacent tissues; there is evidence of metastasis in stage IV, and 77% of the cases can be seen in the lacrimal sac area.

The initial symptoms include tears, chronic dacryocystitis and swelling of the lacrimal sac. Early lacrimal irrigation is smooth. It lasts for several months. The slower the development, the longer the duration of the lacrimal passage, and the later the lacrimal sac skin. Infiltration, like inflammation, but not as severe as acute dacryocystitis, such as blocking the nasolacrimal duct, often accompanied by chronic dacryocystitis, the lacrimal sac tumor is generally painless, the compression of the mass can be found to be hard, but this is not just The hardness of the tumor itself, but the swelling of the deep fascia is increased by the mass, the massage can not be reduced, and the pressure can be painful when the pressure is high.

Unlike benign tumors, malignant tumors of the lacrimal sac can invade the medial malleolus ligament. A few of the lacrimal sac tumors pass through the tear duct to the opening of the punctum, which is seen by the naked eye. Most of the lacrimal sac tumors have symptoms at the beginning of the disease. After gradually increasing, in general, benign tumors have a long course of disease and a wide age distribution.

Examination of lacrimal sac tumor

Pathological examination: different forms of lacrimal sac tumors have different pathological manifestations.

1. Imaging examination including ultrasound examination, CT and MRI can help diagnosis, CT scan can show lesions in the lacrimal sac area, clear the source and extent of the tumor, and if necessary, lacrimal sac imaging.

2. Experimental lacrimal lavage and exploration of purulent discharge reflux or rushing out and lacrimal passage is not clear for the diagnosis of lacrimal sac tumors have hints and reference value.

Diagnosis and identification of lacrimal sac tumor

Diagnostic criteria

According to the medical history and clinical features, combined with imaging findings, the diagnosis of the lacrimal sac tumor can be confirmed, but the nature of the confirmed tumor requires pathological examination.

An important feature of the lacrimal sac tumor is the swelling of the lacrimal sac, which should first be distinguished from the dacryocystitis. Because all tumors have a long course of disease and no acute inflammation, it is easy to distinguish from acute dacryocystitis, chronic dacryocystitis. It can be diagnosed by lacrimal passage and squeezing, because dacryocystitis collapses after pus extrusion, and tumor is impossible. Another difference from chronic dacryocystitis is that the lacrimal sac area is generally not covered. Block, the pressure is grayish white mucus or pus out of the punctum, X-ray film, tears of the cystic sac without bone destruction, lacrimal sac angiography shows that the lacrimal sac is empty, the lateral position of the contrast agent around the mass can help distinguish.

The swelling of all benign tumors is in the lower part of the medial malleolus ligament. The finger is pressed and tested. The cyst is elastic and fluctuating. The surface is smooth, fibroids and myoblastoma, and the sense of compression is substantial. After the papilloma is massaged, Slightly smaller.

Although some malignant tumors are not diagnosed until the medical report is reported, the following diagnostic measures are still useful.

1. The history of malignant tumors is relatively short, and the development speed is faster.

2. The mass must be differentiated from inflammation. Chronic dacryocystitis and benign tumors never cross the medial malleolus ligament; although acute inflammation affects the upper part of the medial malleolar ligament, it should have obvious acute inflammation and signs.

3. The main difference between tumor and chronic dacryocystitis is not only that it feels different when pressed, but also does not shrink due to massage.

4. Radiation examination can help the early stage tumor to help determine the location. For advanced lesions, it is helpful to judge the degree of spread to the surrounding area, or to confirm whether the nasal tumor invades the lacrimal duct and whether there is lymphatic metastasis. This is a characteristic of advanced malignant tumor. The lacrimal sac malignant tumors are mainly the anterior, submandibular and cervical lymph nodes.

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