<b><i>Objective:</i></b> The aim of the study was to describe the clinical presentation, management strategies, and outcomes in a case series of primary lacrimal sac tumors. <b><i>Methods:</i></b> This retrospective study was conducted in Sheikh Fajilatunnessa Mujib Eye Hospital and Training Institute, Bangladesh, from July 1 to December 31, 2020, and included all patients who were evaluated, treated, and followed up for at least 6 months from January 2013 to October 2020. One patient developed a recurrence of the adenocarcinoma of the lacrimal sac after 1 year of primary treatment. Patients’ demographic data were analyzed and reviewed from published articles on lacrimal sac tumors. We assessed patients clinically, followed by radiological evaluation. We also analyzed the biopsy technique, treatment modality, and recurrence. An oncologist reviewed all patients to prepare a plan for adjuvant treatment. <b><i>Results:</i></b> Ten patients with lacrimal sac tumors were included in this study. Swelling in the medial canthal region was the most common presenting feature (100%), followed by epiphora (60%) and pain (30%). Open biopsy was preferred over fine-needle aspiration biopsy. Incisional biopsy or complete excisional biopsy was performed for all suspected malignancies. Malignant tumors were found in 7 (70%) cases, and benign tumors in 3 (30%) cases. Non-Hodgkin’s lymphoma (NHL) (40%) was the most common malignant lacrimal sac tumor. Mucosa-associated lymphoid tissue lymphoma was 75%, and diffuse large B-cell lymphoma was 25% among the cases of NHL. Patients with epithelial malignancy were treated with external beam radiation therapy, while NHL patients were treated with chemotherapy (CHOP regimen). Recurrence was noted in 1 case (10%) of epithelial malignancy after 1 year of treatment. <b><i>Conclusion:</i></b> Successful management of lacrimal sac tumors requires a high index of suspicion, as these are fatal tumors, often misdiagnosed as dacryocystitis. Nonepithelial malignancies are more predominant than epithelial malignancies, and hematolymphoid tumors are most frequent.

To present the demographic and clinical profile and management strategies of patients with periocular and orbital amyloidosis. This study retrospectively reviewed the clinical records of twelve patients with periocular and orbital amyloidosis between January 2011 and February 2019 in Bangladesh. Clinical evaluation and Imaging studies were helpful to diagnosis the patients, but surgical biopsy followed by histopathological study was done to confirm the diagnosis. All cases were investigated to rule out systemic amyloidosis with limited facility and no systemic involvement was found. Informed written consent for surgical procedure and Clinical photographs were taken for all patients for documentation and clinical research. The study included thirteen patients including nine male (69.2%) and four female (30.8%) patients. Among the patients, seven (53.8%) were unilateral and six (46.2%) were bilateral. Clinical signs and symptoms were visible or palpable periocular mass or tissue infiltration in all 13 (100%) cases, mechanical ptosis was observed in 6 (46.2%) cases, and proptosis or globe displacement was found in 4 (30.8%). Age ranges from 25 years to 65 years. The Mean age ± SD was 48.23 ± 10.64 years. Treatment modalities were mainly open surgical biopsy either excision (53.8%) or debulking (46.2%). Periocular and orbital amyloidosis may present with a wide spectrum of clinical findings depending on the location of the disease. The goal of treatment is to preserve function and to prevent sight-threatening complications.

Lacrimal Sac tumors are extremely rare and potentially life threating. It may be primary, secondary and metastasis from distant organ. Lacrimal sac tumors may be broadly classified into epithelial (72%), mesenchymal (12%), lymphoproliferative (11%) and melanocytic (04%). About 72% are malignant; tend to be locally invasive with high recurrence rate. To report three cases of rare primary lacrimal sac tumors. We evaluated three rare case reports on primary lacrimal sac tumors in two tertiary eye hospitals in Bangladesh. 46 year old female, 36 year old male, and a 21-year-old young male, patients presented with mass in the lacrimal sac area. Two of them underwent deep incision biopsy and histopathology revealed Low grade extranodal marginal zone lymphoma (ENMZL). One patient was treated with Radiotherapy and another one with 6-Cycles of CHOP chemotherapy(Cyclophosphamide, Hydroxydaunorubicin, Oncovin,Prednisone). One patient underwent excision biopsy and histopathology reported lacrimal sac haemangiopericytoma. In all cases the lesions were resolved completely. Management of lacrimal sac tumors requires a high index of suspicion, as these are fatal tumor and often misdiagnosed as dacryocystitis. Early and appropriate intervention will help to complete resolution of the tumor as well as to reduce the recurrence. CBMJ 2018 July: Vol. 07 No. 02 P: 45-49

Still, there is no ideal guideline for managing orbital lymphatic-venous malformations. Significant advances have been made in the treatment of lymphatic-venous malformation. Here, we attempt to review the current and recent evidence on management strategies, including sclerotherapy agents, systemic medications, and techniques. The orbital lymphatic-venous malformation is notorious for being very difficult to treat due to risks of morbidity, loss of vision and periocular disfigurement. Management depends on lymphangioma size, cyst type, and location. One option is carefully watching patients without doing any treatment (Observation). The option of surgery has typically been delayed until necessary because of the high recurrence rate, a high risk of morbidity because of injury to the globe, extraocular muscles, vessels, and optic nerve, and it is difficult to remove the entire lesion. Sclerotherapy is famous for reducing the size of orbital lymphangioma. Systemic medication can reduce the size and improve the clinical symptoms where the lesions are difficult to access surgically or with injections. These treatment modalities aim to reduce the size of the lesions, and cosmetic disfigurement and free from pain caused by these lesions, also avoid vision_threatening complications. J. Natl. Inst. Ophthalmol. 2022; 5(2):45-51