Lacrimal Sac Tumors--A Review

Asia Pac J Ophthalmol (Phila). 2017 Mar-Apr;6(2):173-178. doi: 10.22608/APO.201713.


Tumors of the lacrimal sac are rare but their recognition and early management are imperative, as they are locally invasive and potentially life-threatening. Because of their rarity, large clinical studies with statistically significant data on the natural course, management, and prognosis of these neoplasms are unavailable. Current practices are therefore based on a few case series and a small number of isolated case reports. Most tumors are primary and of epithelial origin (60-94%), of which 55% are malignant. Lacrimal sac tumors typically present with epiphora and a palpable mass over the medial canthus and are thus often erroneously diagnosed as chronic dacryocystitis. A full history with clinical and diagnostic workup is essential to plan treatment, which is often multi-disciplinary. Statistically significant associations have been shown with higher tumor staging and size with increased metastatic risk and lower survival rates. Management usually involves complete surgical resection with adjuvant radiotherapy and/or chemotherapy for malignant lesions. Long-term follow-up is required, as recurrences and metastases can occur many years after initial treatment.

Keywords: dacryocystitis; lacrimal sac tumors; secondary nasolacrimal obstruction.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Disease Management*
  • Eye Neoplasms* / classification
  • Eye Neoplasms* / diagnosis
  • Eye Neoplasms* / therapy
  • Humans
  • Lacrimal Apparatus / pathology*
  • Lacrimal Apparatus Diseases* / classification
  • Lacrimal Apparatus Diseases* / diagnosis
  • Lacrimal Apparatus Diseases* / therapy