Melanoma of the lacrimal drainage system: A systematic review

Abstract

Melanoma of the lacrimal drainage system (LDSM) is a rare and subtle condition that is frequently misdiagnosed. In the present work, we conducted a systematic review investigating the clinical features, management, and prognosis of LDSM. A structured search, according to PRISMA criteria, was performed in April 2020 and updated in February 2021 on Pubmed, EMBASE, Cochrane, and SCOPUS. The articles found underwent a double‐reviewer selection and the main data were extracted. After complete screening, 30 articles reporting 38 cases were included. The time from the first symptom to medical contact ranged from 1 month to 4 years. Surgery was the treatment proposed to all patients, with a variable extension of resection. LDSM is a rare disease that is burdened by poor prognosis. Early diagnosis is crucial, even if difficult to achieve. Surgery and radiotherapy are standardized treatments, while targeted therapy and immunotherapy are attractive prospects.

Endoscopic and external dacryocystorhinostomy: A therapeutic proposal for distal acquired lacrimal obstructions

“…15 , 16 However, their distinction is critically important as, in the latter group, specific therapeutical options should be considered; furthermore, several authors have pointed out the importance of dividing secondary cases into oncologic and non-oncologic etiology. 3 , 17 In fact, considering that the non-oncologic obstructions mainly affect the naso-lacrimal duct, so that the surgical options remain almost identical to the primary etiology (EXT-DCR and END-DCR), the oncologic nature of the DALO may involve any level of the lacrimal pathway and present a treatment algorithm that is highly influenced by the histology and infiltration of the surrounding structures of the malignancy. 18 Considering this, a complete assessment of all possible treatments for malignancies of the lacrimal pathway is beyond the scope of this manuscript that mainly analyzes the treatment algorithm for primary and secondary non-oncologic etiologies.…”

“…Excluding lacrimal malignancies, which require specific management related to the histology, 2 , 3 external dacryocystorhinostomy (EXT-DCR) was historically considered the treatment of choice. However, over the past 40 years, increasing evidence has shown that endoscopic endonasal dacryocystorhinostomy (END-DCR) yields comparable results and is associated with several advantages such as the absence of external scar and less surgical time, with the result that the endoscopic approach has gained popularity even if an external approach is still preferred.…”

Melanoma of the lacrimal sac: An extremely rare location From a radiologist perspective

“…In other primary malignant tumors of the lacrimal sac, neither the magnetic resonance signal nor the enhancement can distinguish the histological type. Finally, voluminous tumors may be difficult to distinguish from sinonasal tumors extending to this region [ 6 , 7 ].…”

The importance of clinical presentation on long-term outcomes of external dacryocystorhinostomies: Our experience on 245 cases

“…1 The latter form is most commonly encountered in adulthood and usually affect middle-aged female patients in whom the obstruction can be caused by different local and systemic pathologies. [2][3][4][5][6][7] Regardless of the etiology of the lacrimal obstruction, its main clinical presentation is represented by epiphora that can be associated with chronic dacryocystitis. 8 The latter clinical condition is caused by stagnation of tears and accumulation of mucoid secretions that lead to chronic inflammation of the lacrimal pathway, on which, occasionally, bacterial proliferation may occur (acute infection).…”