J Korean Ophthalmol Soc.  2021 Sep;62(9):1282-1286. 10.3341/jkos.2021.62.9.1282.

Small Cell Neuroendocrine Carcinoma of the Lacrimal Sac Presenting with Lacrimal Duct Obstruction

• Choi YA
• Son J

• KMID: 2520211
• DOI: http://doi.org/10.3341/jkos.2021.62.9.1282

Abstract

Purpose
We report a case of primary small cell neuroendocrine carcinoma arising from the lacrimal sac.
Case summary
A 54-year-old man presented with epiphora that had been present for 1 month. He underwent lacrimal syringe analysis of the lower punctum in the right eye, which demonstrated fluid regurgitation from the upper punctum. Computed tomography revealed a 3.0 × 3.4 × 3.0 cm mass with an ill-defined margin in the right lacrimal sac, which demonstrated invasion of the lacrimal duct and bony destruction of the inferior and medial orbital walls. Incisional biopsy and histologic examination showed that the tumor was composed of small round tumor cells. On the basis of histopathological and immunohistochemical evaluations, a diagnosis of small cell neuroendocrine carcinoma was made. The patient received chemotherapy.
Conclusions
To the best of our knowledge, this is the first case of primary small cell neuroendocrine carcinoma arising from the lacrimal sac in Korea. Small cell neuroendocrine carcinoma in the lacrimal sac should be regarded as a differential diagnosis for patients with a nasolacrimal duct obstruction.

Keyword

Lacrimal duct obstruction, Nasolacrimal duct, Small cell carcinoma