Korean J Ophthalmol.  2013 Apr;27(2):126-129. 10.3341/kjo.2013.27.2.126.

Nasolacrimal Duct Obstruction Caused by Oncocytic Carcinoma

• Jung JH
• Shin DH
• Cho KS
• Choi HY

• KMID: 1503805
• DOI: http://doi.org/10.3341/kjo.2013.27.2.126

Abstract

Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.

Keyword

Nasolacrimal duct; Oxyphilic adenoma

MeSH Terms

Adenoma, Oxyphilic/*complications/pathology/surgery
Humans
Lacrimal Duct Obstruction/*etiology/pathology/surgery
Male
Middle Aged
Nasolacrimal Duct/*pathology/surgery
Neoplasm Recurrence, Local/complications/pathology/surgery
Nose Neoplasms/*complications/pathology/surgery
Reoperation

Figure

• 

  Fig. 1 (A) Left dacryocystography demonstrates nasolacrimal duct obstruction. (B) Computed tomography revealed that the tumor in the left nasal cavity extended to the nasolacrimal duct and sac, and that the mass did not extend into the orbit. (C) Histological examination of the tumor revealed an oncocytic carcinoma; a destructive, infiltrating pattern and tumor cells composed of eccentrically located nuclei with abundant eosinophilic cytoplasm (hematoxylin-eosin, ×400). (D) Pancytokeratin is strongly positive in tumor cells.

• 

  Fig. 2 (A) Orbital computed tomography demonstrated an orbital mass located in the medial wall of the left orbit. (B) The recurrent tumor demonstrates the same morphology as the original tumor. The recurrent tumor is also composed of oncocytic epithelial cells with abundant eosinophilic cytoplasm (hematoxylin-eosin, ×400).

Reference

1. Wakely PE Jr. Oncocytic and oncocyte-like lesions of the head and neck. Ann Diagn Pathol. 2008. 12:222–230.

2. Anderson NG, Wojno TH, Grossniklaus HE. Clinicopathologic findings from lacrimal sac biopsy specimens obtained during dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2003. 19:173–176.

3. Gnepp DR, Henley JD, Roderick HW. Gnepp DR, editor. Salivary and lacrimal glands: oncocytic lesions and tumors. Diagnostic surgical pathology of the head and neck. 2009. Philadelphia: Saunders Elsevier;413–561.

4. Gray SR, Cornog JL Jr, Seo IS. Oncocytic neoplasms of salivary glands: a report of fifteen cases including two malignant oncocytomas. Cancer. 1976. 38:1306–1317.

5. Nakada M, Nishizaki K, Akagi H, et al. Oncocytic carcinoma of the submandibular gland: a case report and literature review. J Oral Pathol Med. 1998. 27:225–228.

6. Corbridge RJ, Gallimore AP, Dalton CG, O'Flynn PE. Oncocytomas of the upper jaw. Head Neck. 1996. 18:374–380.

7. Hamperl H. Benign and malignant oncocytoma. Cancer. 1962. 15:1019–1027.

8. Hamperl H. Onkocytoma of the salivary glands. Z Krebsforsch. 1962. 64:427–440.

9. Cohen MA, Batsakis JG. Oncocytic tumors (oncocytomas) of minor salivary glands. Arch Otolaryngol. 1968. 88:71–73.

10. Mahmoud NA. Malignant oncocytoma of the nasal cavity. J Laryngol Otol. 1979. 93:729–734.

11. DiMaio SJ, DiMaio VJ, DiMaio TM, et al. Oncocytic carcinoma of the nasal cavity. South Med J. 1980. 73:803–806.

12. Savic D, Djeric D, Jasovic A. Oncocytoma of the nose and ethmoidal and sphenoidal sinuses. Rev Laryngol Otol Rhinol (Bord). 1989. 110:481–483.

13. Fayet B, Bernard JA, Zachar D, et al. Malignant nasal oncocytoma disclosed by mucocele of the lacrimal sac with hemolacrimia. J Fr Ophtalmol. 1990. 13:153–158.

14. Martin H, Janda J, Behrbohm H. Locally invasive oncocytoma of the nasal cavity. Zentralbl Allg Pathol. 1990. 136:703–706.

15. Harrison DF, Lund VJ. Tumours of the upper jaw. 1993. Edinburgh: Churchill Livingstone;108.

16. Forster C, Ostertag H. Oncocytoma of the nose: a case report and review of the literature. Pathologe. 1995. 16:431–433.

17. Nayak DR, Pillai S, Balakrishnan R, et al. Malignant oncocytoma of the nasal cavity: a case report. Am J Otolaryngol. 1999. 20:323–327.

18. Abe T, Murakami A, Nakajima N, et al. Oncocytic carcinoma of the nasal cavity with widespread lymph node metastases. Auris Nasus Larynx. 2007. 34:393–396.

19. Hu YW, Lin CZ, Li WY, et al. Locally advanced oncocytic carcinoma of the nasal cavity treated with surgery and intensity-modulated radiotherapy. J Chin Med Assoc. 2010. 73:166–172.