Squamous Cell Carcinoma of the Lacrimal Sac: A Case and Literature Review

Lacrimal sac squamous cell carcinoma is rare and often presents with unspecific symptoms of associated chronic dacryostenosis or dacryocystitis and may be falsely diagnosed as dacryocystitis. A chronically ill looking 73-year-oldcaucasian, who is a house wife, presented with excessive lacrimation in the right eye of 15 months duration and a right inner canthal mass of 6 months duration. The finding of a painless 2cm firm rubbery and smooth mass in the right medial canthus in addition to the symptoms prompted a diagnosis of chronic dacryocystitis and antibiotic therapy was initiated. However, there was no improvement with therapy. Further investigations, including magnetic resonance imaging (MR) were performed. Although the imaging suggested an inflammatory or infectious etiology, because of the suspicion of the malignancy, complete excision of the tumour, periosteum of the lacrimal fossa and nasolacrimal duct was performed via a medial orbitotomy. Histopathological examination revealed infiltrative well-differentiated highly keratinized squamous cell carcinoma arising from lacrimal sac. Herein, we report a case of squamous cell carcinoma of the lacrimal sac mimicking chronic dacryocystitis.