Two cases of primary malignant melanoma of the lacrimal sac

Background. Malignancy of the lacrimal sac is rare, and primary malignant m elanoma in this region is extremely rare. Methods. We report two cases of malignant melanoma of the lacrimal sac pres ented with epiphora and a palpable mass in the medial canthal area. We perf ormed radical surgery and radiation therapy. Results. The light microscopic, immunohistochemical, and electron microscop ic studies confirmed the diagnosis. One of the patients, a 65-year-old-woma n, has no evidence of recurrence or distant metastasis 3 years after surger y and radiotherapy, whereas another patient, a 56-year-old man, died of dis tant metastasis 6 months after surgery and radiotherapy. Conclusions. We present two cases of malignant melanoma of the lacrimal sac that masqueraded as chronic dacryocystitis. Head and neck surgeons should be aware of this disease entity when encountered with patients with epiphor a and mass in the medial canthal area. (C) 2001 John Wiley & Sons, Inc.