Lacrimal Sac Tumors
Rare growths in the tear-drainage sac
Quick Facts
- Type: Tumor of the tear-drainage system
- Location: Lacrimal sac, inner corner of the eye
- Behavior: Can be benign or malignant
- Key sign: Tearing with a lump, sometimes bloody
Overview
The lacrimal sac is part of the tear-drainage system. It sits just beside the inner corner of the eye and collects tears before they flow down a duct into the nose. A lacrimal sac tumor is an uncommon growth that develops in this sac. These tumors can be noncancerous (benign) or cancerous (malignant), and both can interfere with tear drainage.
Because problems in the tear sac more often come from infection or blockage, a tumor can be overlooked at first. Certain warning signs, such as a firm lump above the level of the tear sac, persistent one-sided tearing, or blood-tinged tears, should raise concern for a tumor and prompt further evaluation. Early diagnosis allows for the best treatment, which often involves surgery.
Symptoms
Symptoms develop near the inner corner of the eye and usually affect one side.
- Persistent watery, overflowing eye (tearing) on one side
- A firm lump or swelling at or above the inner corner of the eye
- Discharge from the tear-drainage opening, which may be blood-tinged
- Recurrent tear-sac infections that keep coming back
- Pain or tenderness in the area in some cases
- Bulging of the eye or vision changes if a larger tumor extends nearby
A lump that is firm and located above the tear sac, rather than below, is a particularly important warning sign for a tumor.
Causes
The exact cause of most lacrimal sac tumors is not known. They arise from the cells lining the tear sac or nearby tissues. Tumors can be:
- Benign: Such as papillomas or other noncancerous growths
- Malignant: Various types of cancer that begin in the lining or other cells of the sac
Long-standing inflammation of the tear-drainage system may play a role in some cases. These tumors are not caused by anything a person did, and they are not contagious.
Risk Factors
- Middle age and older, when most cases occur
- Long-standing or recurrent tear-sac inflammation or infection in some cases
Lacrimal sac tumors are rare, and most people have no identifiable risk factor. There are no well-established lifestyle causes.
Diagnosis
Diagnosis combines examination, imaging, and a tissue sample:
- Eye and tear-system examination: The clinician feels for a lump and assesses tear drainage; a mass above the tear sac is a red flag.
- Imaging: CT or MRI scans show the size and extent of the growth and whether nearby structures are involved.
- Dacryocystography or related tests: May be used to study the tear-drainage system.
- Biopsy: A tissue sample, often obtained during surgery, confirms whether the tumor is benign or malignant and identifies its type.
Treatment
Treatment depends on whether the tumor is benign or malignant and how far it extends. Surgery is usually central to care.
- Surgical removal: The tumor and affected part of the tear sac are removed; the extent depends on the type and spread.
- Additional treatment for cancer: Radiation therapy, and sometimes chemotherapy, may be added for malignant tumors.
- Restoring tear drainage: Procedures to re-establish tear flow may be done after the tumor is removed.
- Follow-up: Regular monitoring is important, especially for malignant tumors, to watch for recurrence.
The outlook is generally good for benign tumors and depends on the type and stage for malignant ones, which is why early diagnosis matters.
Prevention
There is no known way to prevent lacrimal sac tumors, since their cause is largely unknown. The most useful step is prompt evaluation of warning signs, especially a firm lump at the inner corner of the eye, persistent one-sided tearing, blood-tinged discharge, or repeated tear-sac infections, so that a tumor can be identified and treated early rather than mistaken for a simple blockage or infection.
When to See a Doctor
See an eye doctor if you have ongoing one-sided tearing, a firm lump at the inner corner of the eye, blood-tinged discharge from the eye, or repeated tear-sac infections that keep returning despite treatment. Seek prompt care if a lump in this area is growing, if you develop a bulging eye, double vision, or new vision changes, which may mean a tumor is extending into nearby tissue and needs urgent assessment.
Frequently Asked Questions
What is a lacrimal sac tumor?
It is an uncommon growth in the tear sac, the part of the tear-drainage system near the inner corner of the eye. These tumors can be benign or cancerous, and both can block tear flow and cause persistent watering on one side.
What are the warning signs of a lacrimal sac tumor?
Key signs include a firm lump at or above the inner corner of the eye, persistent one-sided tearing, blood-tinged discharge, and tear-sac infections that keep returning. A lump located above the tear sac is especially concerning for a tumor.
How is a lacrimal sac tumor diagnosed?
An eye doctor examines the tear-drainage system, and imaging such as a CT or MRI scan shows the size and extent of the growth. A biopsy, often taken during surgery, confirms whether it is benign or malignant and identifies the type.
How are lacrimal sac tumors treated?
Treatment usually involves surgery to remove the tumor, with the extent depending on its type and spread. Malignant tumors may also need radiation or chemotherapy, and procedures may restore tear drainage afterward, along with regular follow-up.
References
- American Academy of Ophthalmology. Lacrimal Sac Tumors.
- National Cancer Institute (NCI). Eye Cancer.
- MedlinePlus, U.S. National Library of Medicine. Eye and orbit tumors.
- StatPearls, National Library of Medicine. Lacrimal Sac Tumors.