title: Unilateral Alacrima as a Presenting Symptom of Nasopharyngeal Carcinoma.
abstract: Advanced nasopharyngeal carcinoma may present to oculoplastic surgeons and ophthalmologists as epiphora or medial canthus swelling. In contrast, the authors describe an uncommon initial presentation of alacrima in a 30-year-old female with nasopharyngeal carcinoma without invasion of the nasolacrimal sac, duct, or lacrimal gland. The diagnosis was delayed due an initial misdiagnosis of dry eye. Nasopharyngeal carcinoma should be included in the differential for diminished tear production, especially if it presents asymmetrically.
authors.affiliation: *Division of Ophthalmic Plastic and Reconstructive Surgery, Shiley Eye Institute, University of California San Diego, San Diego, California, †Division of Plastic Surgery, University of California San Diego, San Diego, California, and ‡Bascom Palmer Eye Institute, University of Miami, Miami, Florida, U.S.A.
authors.forename: Audrey C
authors.initials: AC
authors.lastname: Ko
authors.forename: Kellie R
authors.initials: KR
authors.lastname: Satterfield
authors.forename: Bradford W
authors.initials: BW
authors.lastname: Lee
authors.forename: Ramzi M
authors.initials: RM
authors.lastname: Alameddine
authors.forename: Bobby S
authors.initials: BS
authors.lastname: Korn
authors.forename: Don O
authors.initials: DO
authors.lastname: Kikkawa
mesh_terms: D000328:Adult; D002277:Carcinoma; D003937:Diagnosis, Differential; D015352:Dry Eye Syndromes / Q000175:diagnosis; D015785:Eye Diseases, Hereditary / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis*; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis*; D013666:Tears / Q000378:metabolism