Oncocytic carcinoma of the nasolacrimal duct treated by transnasal endoscopic resection.

BACKGROUND: Malignancies of the nasolacrimal apparatus are rare lesions that usually originate from the lacrimal sac. To the best of our knowledge, this is the first case of a primary oncocytic carcinoma of the nasolacrimal duct reported in the literature.

METHODS: A 43-year-old woman presented with a 3-month history of right epiphora. At nasal endoscopy, an exophytic lesion occupying the right inferior meatus was visible. Imaging studies showed an expansile lesion involving the nasolacrimal duct and the inferior meatus, but not invading the orbit or adjacent soft tissues. A biopsy was suggestive for an oncocytic lesion.

RESULTS: A radical resection was obtained through an endoscopic extended medial maxillectomy with a definitive diagnosis of oncocytic carcinoma. Forty-two months after surgery there was no evidence of disease.

CONCLUSIONS: In selected malignant lesions of the nasolacrimal duct not involving the adjacent soft tissues or lacrimal sac, an exclusive endoscopic approach can be considered.