title: Adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct: a case report.
abstract: OBJECTIVE
  To present the clinical presentation, workup, surgical approach, and pathological findings of the first case report of a patient with adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct.
  
  
  METHODS
  Retrospective review of the records of a case of adenocarcinoma ex-pleomorphic adenoma of the lacrimal sac and nasolacrimal duct.
  
  
  METHODS
  The clinical presentation, workup, surgical approach, and pathological findings were reviewed.
  
  
  RESULTS
  A 51-year-old man presented with a 10-year history of recurrent epiphora of the right eye. At dacryocystorhinostomy a small lesion was visualized within the lumen of the lacrimal sac. A biopsy specimen was consistent with adenocarcinoma. En bloc resection was accomplished using a lateral rhinotomy and medial maxillectomy. The final specimen showed adenocarcinoma ex-pleomorphic adenoma. The patient was given postoperative radiation therapy. He was free of disease 16 months after treatment.
  
  
  CONCLUSIONS
  Lacrimal sac tumors should be considered in the differential diagnosis of chronic epiphora. Management of nasolacrimal adenocarcinoma requires complete surgical resection. Radiation treatment in and of itself is not curative but may be useful as adjuvant therapy. Carcinoma ex-pleomorphic adenoma can develop in the lacrimal sac and nasolacrimal duct.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103-2714, USA. baredeso@umdnj.edu
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Ludwin
authors.forename: Yolanda L
authors.initials: YL
authors.lastname: Troublefield
authors.forename: Paul D
authors.initials: PD
authors.lastname: Langer
authors.forename: Neena
authors.initials: N
authors.lastname: Mirani
mesh_terms: D008949:Adenoma, Pleomorphic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003131:Combined Modality Therapy; D003608:Dacryocystorhinostomy; D005134:Eye Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor