Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5684
Peer-review started: June 18, 2020
First decision: September 23, 2020
Revised: October 1, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: November 26, 2020
Processing time: 160 Days and 13.2 Hours
Here we present a rare case of localized amyloidosis involving the nasolacrimal duct and lacrimal sac which was managed by endoscopic surgery.
A 50-year-old man whose medical history included bilateral ventricular fold and vocal cord amyloidosis complained of bilateral epiphora. Magnetic resonance imaging revealed a neoplasm within the nasolacrimal sac. Characteristic positivity for Congo red staining and birefringence under a polarized microscope proved the diagnosis of amyloidosis. Dacryocystorhinostomy via an endoscope obtained a favorable result. A one-year follow-up found no recurrence.
There are few reports on amyloidosis involving the lacrimal outflow system, and management and outcome are not clear. Endoscopic dacryocystorhinostomy can be a choice to relieve symptoms. Regular follow-up and monitoring of systemic diseases are highly recommended.
Core Tip: A 50-year-old man was admitted with bilateral epiphora for 2 years and an enlargement of the lacrimal sac in his left eye for 3 mo. His medical history included bilateral ventricular fold and vocal cord amyloidosis followed by a neoplasm of the tongue base. Pathological examinations showed positive congo red staining with apple-green birefringence under polarized light. Endoscopic left dacryocystorhinostomy was performed to remove the mass in the nasolacrimal duct and lacrimal sac and achieved no recurrence during 1-year follow-up. Regular follow-up and monitoring of systemic diseases are highly recommended.