Nasolacrimal relapse of nasopharyngeal carcinoma.
OBJECTIVE
To describe three rare cases of nasolacrimal relapse of nasopharyngeal carcinoma, and to discuss the route of tumour spread from nasopharynx to lacrimal system as well as the relevant computed tomography findings.


METHODS
We report three cases of nasolacrimal relapse in patients with previously treated nasopharyngeal carcinoma. The common initial presentations in these cases were epiphora and medial canthal swelling. The tumour spread from the nasopharynx to the lacrimal sac along the lateral nasal wall and nasolacrimal canal. Computed tomography demonstrated nasolacrimal canal invasion and osteomeatal complex obliteration by the tumour. Distant metastasis was detected in two cases.


CONCLUSIONS
More targeted radiotherapy should be delivered to prevent under-treatment of nasopharyngeal carcinoma. Nasolacrimal relapse of nasopharyngeal carcinoma is an advanced disease with a poor prognosis.
ORL Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. kj_sia@yahoo.com
K J
KJ
Sia
I P
IP
Tang
C K L
CK
Kong
T Y
TY
Tan
D000328:Adult; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging / Q000473:pathology*; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed