Lacrimal sac tumors: A case series over 27 years.

PURPOSE: This study aims to document and analyze the clinical characteristics, diagnostic approaches, and treatment outcomes of lacrimal sac tumors in a tertiary eye hospital in Saudi Arabia. METHODS: A retrospective review was conducted of medical records from patients presenting with lacrimal sac tumors at King Khaled Eye Specialist Hospital between 1997 and April 2024. Demographic data, presenting symptoms, diagnostic imaging results, histopathological diagnoses, treatment modalities, and follow-up outcomes were analyzed. RESULTS: A case series of 13 patients with histopathologically confirmed lacrimal sac tumors was included in the study. The cohort consisted of 6 males and 7 females, with a mean age of 42 years. The majority of tumors were benign (61.5%), with atypical lymphoid hyperplasia being the most common (46%). Malignant tumors comprised 38% of cases, including squamous cell carcinoma and various lymphomas. Common presenting symptoms were epiphora (92%) and medial canthal swelling (68.4%). Surgical excision was the primary treatment modality, supplemented by radiotherapy for lymphomas. The overall recurrence rate was 15%, with no direct tumor-related mortality observed. CONCLUSION: Lacrimal sac tumors in this population predominantly presented as benign lesions, with a lower malignancy rate compared to previous reports. The study highlights the importance of early diagnosis and individualized treatment strategies. Future research with larger sample sizes and longer follow-up periods is necessary to develop standardized management protocols and improve patient prognoses.