Nasolacrimal tumours, in other words tumours involving the nasolacrimal drainage apparatus, are uncommon, and have a variety of histologies.
Clinical presentation of nasolacrimal tumours are typically fairly non-specific, often resulting in delayed diagnosis 1. Typical presentations include 1:
- mass in the region of the nasolacrimal sac
A number of histologies are encountered including 1:
- squamous cell papilloma
- squamous cell carcinoma (most common)
- transitional cell papilloma
- transitional cell carcinoma
- adenoid cystic carcinoma
- malignant melanoma
Additionally the nasolacrimal apparatus can be involved by direct spread from adjacent cutaneous or sinonasal tumours.
Due to the small calibre of the nasolacrimal duct, symptoms may be present before easily detectable radiographic abnormalities become evident. When larger, these tumours are difficult to distinguish these form cutaneous or sinonasal tumours with direct extension into the region.
When evident on imaging, most masses appear as soft tissue lesions involving the medial canthus region. Masses of the nasolacrimal duct may demonstrate bony remodelling and widening of the lacrimal bony canal 1.
The appearance on MRI is usually non-specific with a moderately enhancing mass in the region of the medial canthus 1. Careful examination of the infraorbital canal is warranted to assess for perineural spread.