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Type: Journal article
Title: En bloc excision in malignant tumors of the lacrimal drainage apparatus
Author: Valenzuela, A.
Selva-Nayagam, D.
McNab, A.
Simon, G.
Sullivan, T.
Citation: Ophthalmic Plastic and Reconstructive Surgery, 2006; 22(5):356-360
Publisher: Lippincott Williams & Wilkins
Issue Date: 2006
ISSN: 0740-9303
Abstract: <h4>Purpose</h4>To describe the surgical technique and results of en bloc excision in a series of patients with extensive malignant tumors of the lacrimal drainage apparatus (LDA).<h4>Methods</h4>This was a noncomparative, retrospective chart review of the clinical and pathologic findings of 11 patients presenting with a malignant tumor affecting the LDA who underwent en bloc excision of the lacrimal system.<h4>Results</h4>Of the 11 patients, 7 were male. The mean age at presentation was 58 years (range, 39 to 81 years), and all cases were unilateral. Histopathology revealed 4 squamous cell carcinomas, 3 transitional cell carcinomas, 2 mucoepidermoid carcinomas, and 2 melanomas. Epiphora and a mass were the most common presentations. An external lesion could be identified in 4 cases. Irrigation of the lacrimal system revealed nasolacrimal duct obstruction in 2 cases and common canaliculus obstruction in another 2 patients. The entire LDA and surrounding bony tissues were excised through a lateral rhinotomy approach. Adjuvant radiotherapy was given in 4 cases. Nine patients remain alive and well after a mean follow-up of 2 years (range, 6 months to 7 years). Three cases showed distant disease and 2 patients died of metastatic melanoma involvement.<h4>Conclusions</h4>The use of en bloc excision as a radical treatment to remove the complete LDA and surrounding bony structures affords good local tumor control and may provide the best opportunity for enhanced patient survival.
Keywords: Lacrimal Apparatus
Eye Neoplasms
Tomography, X-Ray Computed
Treatment Outcome
Ophthalmologic Surgical Procedures
Retrospective Studies
Follow-Up Studies
Aged, 80 and over
Middle Aged
DOI: 10.1097/01.iop.0000235819.06507.b1
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