En bloc excision in malignant tumors of the lacrimal drainage apparatus

被引:30
作者
Valenzuela, Alejandra A.
Selva, Dinesh
McNab, Alan A.
Simon, Guy B.
Sullivan, Timothy J.
机构
[1] Royal Brisbane & Womens Hosp, Eyelid Lacrimal & Orbital Clin, Dept Ophthalmol, Div Surg, Brisbane, Qld, Australia
[2] Univ Queensland, Sch Med, St Lucia, Qld 4067, Australia
[3] Univ Adelaide, Dept Ophthalmol & Visual Sci, Dept Surg, Adelaide, SA 5005, Australia
[4] Univ Adelaide, Dept Med, Adelaide, SA 5005, Australia
[5] Royal Victorian Eye & Ear Hosp, Orbital Plast & Lacrimal Clin, Melbourne, Vic 3002, Australia
关键词
D O I
10.1097/01.iop.0000235819.06507.b1
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: 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). Methods: 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. Results: 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. Conclusions: 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.
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收藏
页码:356 / 360
页数:5
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