Tear duct cancers
Rare cancers of the lacrimal drainage system, where Mr Gane and his Moorfields colleagues hold the largest published case series in the world.
Cancers of the lacrimal drainage system are very rare. They arise in the tear sac or the tear duct itself and most often present as a persistent watering eye that does not respond to usual treatment, or as a firm swelling beside the nose at the inner corner of the eye. Because they are uncommon, they can be missed and treated for months as a routine blocked tear duct.
Signs that need a careful look
- A constantly watering eye that does not settle with the usual treatment
- A firm or fixed swelling beside the nose, beyond what a tear-sac infection would explain
- Bleeding from the tear ducts (blood in the tears)
- Numbness of the cheek, double vision, or a swelling that has changed in size or character
Why specialist assessment matters
Mr Gane runs the joint nose-and-eye lacrimal service at Moorfields Eye Hospital with his ophthalmology and oculoplastic colleagues. Together they have published the largest case series of lacrimal drainage tumours in the world literature, which informs how the service identifies, investigates and treats them today. Patients with a suspected tear-duct cancer are reviewed jointly so that diagnosis and the right surgical and oncological plan are agreed in one visit where possible.
Assessment
Assessment includes a careful history and examination, endoscopy of the inside of the nose and of the tear-sac opening, and imaging with CT or MRI. A tissue diagnosis (biopsy) is needed before any major treatment decision. Where infection has been treated first and the swelling has not settled, biopsy is brought forward.
Treatment
Treatment depends on the type and stage of the tumour and is decided in a head and neck or skull-base multidisciplinary meeting. Surgery to remove the tumour with a margin is the usual first step. Depending on the diagnosis, this may be combined with radiotherapy, with chemotherapy or immunotherapy, or with reconstruction of the tear drainage system. The plan is explained at each step.
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This page is general information and not a substitute for individual medical advice.