BÁO CÁO CA LÂM SÀNG U NHÚ ĐẢO NGƯỢC TRONG TÚI LỆ VÀ HỒI CỨU Y VĂN

Abstract

Inverted papilloma of the lacrimal sac are extremely rare. Although histologically benign, these tumors are locally invasive, have a high tendency to recur, and have a risk of malignant transformation. These tumors may be discovered incidentally, or they cause symptoms of mimic nasolacrimal duct obstruction. We discovered a case of inverted papilloma of the lacrimal sac during endoscopic nasolacrimal duct anastomosis. The 38-year-old male patient had undergone endoscopic placement of a silicone tube for the lacrimal duct of the left eye 2 years ago. During the surgery, we found a polyp in the inferior meatus and removed the entire mass for pathology - then performed endoscopic sinus surgery to remove the tumor twice at the Central Ear, Nose and Throat Hospital (pathology result: inverted papilloma). One year after the second surgery at the Vietnam National Eye Hospital, the patient had increased recurrent tearing in the left eye. The tumor had not recurred through nasal endoscopy for 6 months since the second surgery to remove the nasal papilloma, so we performed endoscopic nasal lacrimal sac anastomosis for the patient. During surgery, when incising the lacrimal sac, we found a lot of papilloma-like tissue. We removed as much as possible for pathological anatomy and placed a silicone tube. Immediately after surgery and up to now 5 months after surgery, the patient has no tears. The patient went back for a check-up, had the silicone tube removed and had another recurrent papilloma in the nasal cavity removed from the old lacrimal sac location through nasal endoscopy for pathological anatomy (the results still confirmed that it was an inverted papilloma and there were no malignant cells). Pumping the lacrimal duct, normal flow was observed to drain into the nose. Through this clinical case, we reviewed the clinical, paraclinical and treatment results in the medical literature, emphasizing the importance of preoperative assessment.