PRIMARY ADENOID CYSTIC CARCINOMA OF THE LACRIMAL SAC - REPORT OF A CASE

A 41-year-old white woman presented with a 1-month history of epiphora and a painless medial canthal mass on the left that was unresponsive to antibiotic treatment. Computerized tomography (CT) and magnetic res onance imaging (MRI) scans delineated a soft tissue mass with bony des truction originating in the area of the left lacrimal sac with extensi on into the maxillary and ethmoid sinuses and inferomedial orbit. Open biopsy of the mass revealed adenoid cystic carcinoma (ACC). On surgic al exploration, the tumor was found to originate from the lacrimal sac wall. Radical surgery with wide excision of surrounding bone and peri orbital tissue was performed in light of the histological diagnosis an d tumor extension. Orbital exenteration was not performed in order to preserve the patient's left eye. A 6-week course of adjunctive radioth erapy was applied without complication. The patient was clinically and radiologically free of tumor at 1-year follow-up. This case represent s only the third time that primary ACC arising from the lacrimal sac h as been reported.