Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery ; Humans ; Lacrimal Duct Obstruction/*etiology/pathology/surgery ; Male ; Middle Aged ; Nasolacrimal Duct/*pathology/surgery ; Neoplasm Recurrence, Local/complications/pathology/surgery ; Nose Neoplasms/*complications/pathology/surgery ; Reoperation

Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery ; Humans ; Lacrimal Duct Obstruction/*etiology/pathology/surgery ; Male ; Middle Aged ; Nasolacrimal Duct/*pathology/surgery ; Neoplasm Recurrence, Local/complications/pathology/surgery ; Nose Neoplasms/*complications/pathology/surgery ; Reoperation

OBJECTIVETo analyze the clinical and imaging characteristics of patients with cystic lesions in sella region and to describe the experience of endoscopic transsphenoidal surgery.

METHODSFourty-six cases of cystic lesions in sella region confirmed by surgery and pathology between June 2003 and September 2013 were retrospectively analysed. The clinical features, imaging, surgical technique and postoperative recurrence in 46 cases were presented.

RESULTSAll lesions were resected through transsphenoidal endoscopic endonasal approach. Followed up lasted from 6 months to 6 years. Postoperatively, headache was recovered in 26 cases and wasn't recovered in 8 cases, visual was improved in 12 cases and wasn't improved in 2 cases, hypopituitarism was relieved in 18 cases and wasn't relieved in 15 cases, polyuria was disappeared in 8 cases and wasn't disappeared in 4 cases. Seven cases recurred, including 4 cases of craniopharyngioma, 2 cases of pituitary abscess, 1 case of cystic adenoma. There were no death and serious complication. The small age of onset, visual acuity and visual field symptoms, tumor in suprasellar, third ventricle compression was easy to occur in craniopharyngioma; cystic tumor, cavernous sinus invasion, the solid part homogeneous enhancement could be seen in cystic adenoma; Rathke cyst showed simple cystic, lighter clinical symptoms and a short course. Prone to diabetes insipidus, low multiple hormone level and the lesions of annular enhancement was more common in pituitary abscess.

CONCLUSIONSThe clinical features and imaging of cystic lesions in sella region feature overlap each other, but there are certain specificity. Transsphenoidal endoscopic endonasal approach for the surgery of cystic lesions in sella is effective and safe.

Abscess ; complications ; Adenoma ; complications ; Craniopharyngioma ; complications ; Cysts ; surgery ; Endoscopy ; methods ; Headache ; complications ; Humans ; Hypopituitarism ; complications ; Neoplasm Recurrence, Local ; Nose ; Pituitary Diseases ; surgery ; Pituitary Neoplasms ; complications ; Retrospective Studies ; Sella Turcica ; pathology