Clinical features and management of XXXX affecting the lacrimal drainage apparatus.

@entity1 @entity706 @entity5 @entity1185 @entity262 @entity189 @entity9467 @entity5932 @entity3 @entity4578
PURPOSE: To report the clinical features of a series of @entity1 with lacrimal drainage @entity5 and present guidelines for management based on histopathology. METHODS: A non-comparative retrospective chart review of the clinical, imaging, and pathologic findings of 37 @entity1 presenting to four regional orbital surgery departments with @entity5 affecting the lacrimal drainage apparatus between 1990 and 2004. RESULTS: There were 37 @entity1 , of whom 62% were male. The mean age at referral was 54 years. @entity9467 , a palpable mass, and @entity4578 were the most common presentations. Two thirds of the @entity5 were epithelial, with @entity189 being the most frequent (38%), followed by @entity1185 (27%). @entity706 were the most common nonepithelial malignancy (30%). @entity5 were more common in @entity1 (87%), whereas @entity706 were more common in @entity1 (57%). Treatment modalities included surgery, in addition to radiotherapy and/or chemotherapy and immunotherapy. Mean follow-up was 38 months. Thirty-three @entity1 (89%) remain alive without evidence of disease and 4 @entity1 died of recurrence and/or @entity3 . CONCLUSIONS: Lacrimal drainage @entity5 require careful initial management to ensure adequate local and @entity262 control. @entity5932 encountered during dacryocystorhinostomy should be biopsied and small @entity1185 or pedunculated @entity5 excised and analyzed with frozen sections. If a diffuse or infiltrative mass is encountered, it should be biopsied and managed on the basis of histopathology and extent of disease. @entity706 should be treated according to protocols, whereas noninvasive @entity189 and @entity1185 require complete excision of the system. @entity3 requires en bloc excision. Long-term follow-up is essential for early detection of recurrence.
