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Malignant melanoma of the lacrimal sac: a case report
Author(s) -
Maegawa Jiro,
Yasumura Kazunori,
Iwai Toshinori,
Hata Masaharu,
Inayama Yoshiaki,
Kobayashi Shinji
Publication year - 2014
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2012.05480.x
Subject(s) - reconstructive surgery , medicine , ophthalmology , general surgery
A 61-year-old patient had noticed a mass in the medial canthal region of the left palpebra for about one year. He visited an ophthalmologist because the mass gradually grew, and there were bloody clots from the left nasal cavity. The ophthalmologist referred the patient to our hospital suspecting malignancy. During the first visit, the patient complained of epiphora, a mass 34 · 23 mm in size, and slight pain in the medial canthal region (Fig. 1) without obvious metastases to regional lymph nodes and transit lesions in the canthal region and nasal mucosa. Computed tomography and magnetic resonance imaging (Fig. 2) revealed a clearly defined mass occupying the lacrimal sac and duct, expanding into the surrounding bone and soft tissue. A biopsy specimen revealed typical characteristics of malignant melanoma. Carbon ion radiotherapy was then considered as the first choice of treatment for the head and neck region; this up-to-date radiotherapy was available at a nearby specialist institute. However, a positron emission tomography scan performed to identify distant metastases revealed multiple liver metastases, which were clinical stage IV in this patient. According to the protocol for