Clinical Features And Imaging Findings of Early Lacrimal Sac Neoplasms

Abstract Background To examine the clinical features and imaging findings of early-stage lacrimal sac neoplasms. Methods In this retrospective study, patients presenting with epiphora were diagnosed with either lacrimal sac neoplasms or mucoceles. Diagnostic assessments included computed tomography (CT), enhanced magnetic resonance imaging (MRI), and pathological analysis. Results The study comprised nine patients (2 male; 7 female) with lacrimal sac neoplasms, 44% of whom had malignancies while 56% exhibited benign conditions. There was no statistically significant difference in the mean width of the nasolacrimal canal between patients with neoplasms (6.49 ± 3.68 mm) and mucoceles (5.50 ± 1.88 mm, P = 0.44). However, the depth of the nasolacrimal canal was significantly greater in the neoplasm group (5.08 ± 3.21 mm) compared to the mucocele group (2.85 ± 0.96 mm, P = 0.05). Notably, lacrimal sac mass extended above the medial canthal tendon in eight neoplasm patients, unlike any in the mucocele group, demonstrating distinct pathological presentations. Additionally, the diseased eyes in the neoplasm group showed significantly greater nasolacrimal canal width (6.49 mm) compared to the contralateral eyes (3.01 mm, P = 0.01) and a slightly deeper depth (5.08 mm vs. 2.66 mm, P = 0.04). Conclusions Findings suggest that a lacrimal sac mass extending above the medial canthal tendon warrants a CT scan. Patients with a nasolacrimal canal wider than the contralateral side should undergo enhanced MRI for accurate diagnosis and treatment planning.