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Endoscopic dacryocystorhinostomy is emphasized for early-stage disease, while advanced tumours typically require more aggressive external approaches plus adjuvant radiotherapy and chemotherapy. Lack of shared staging limits standardization and comparison; the rarity and histologic heterogeneity make multidisciplinary management essential.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/exclusive-or-combined-endoscopic-approach-to-tumours-of-the-lower-lacrimal-pathway-review-of-the-literature/341213/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/exclusive-or-combined-endoscopic-approach-to-tumours-of-the-lower-lacrimal-pathway-review-of-the-literature/341213.png","ImageObject",300,407,{"name":42,"@type":43},"Ivy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-28","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the purpose and scope of the literature review?","Question",{"text":63,"@type":64},"To assess the role of minimally invasive endoscopic treatments for lacrimal pathway neoplasms. It analyzed 316 patients with benign or malignant tumours of the lacrimal drainage system.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which tumours were most common based on histologic findings?",{"text":68,"@type":64},"Squamous cell carcinoma was the most prevalent, followed by lymphatic neoplasms and melanomas.",{"name":70,"@type":61,"acceptedAnswer":71},"How do treatment strategies differ between early-stage and more extensive tumours?",{"text":72,"@type":64},"For early-stage tumours confined to the lacrimal fossa, minimally invasive endoscopic approaches such as endoscopic dacryocystorhinostomy are emphasized. For more extensive tumours, more aggressive external approaches are required, typically with adjuvant radiotherapy and chemotherapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},341213,1790591018,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","ACTA OTORHINOLARYNGOLOGICA ITALICA 2024;44(SUPPL.1):S67-S81; doi: 10.14639/0392-100X-suppl.1-44-2024-N2966  \nRhinology  \nExclusive or combined endoscopic approach to tumours of the lower lacrimal pathway:  \nreview of the literature  \nGiuseppe Campobasso1 , Maria Sterpeta Ragno2 , Alessandro Monda2 , Silvana Ciccarone1 , Alessandro Maselli del Giudice1 , Francesco Barbara2 , Giacomo Gravante3 , Paolo Lucchinelli3 , Alberto Daniele Arosio3 , Luca Volpi4 , Maurizio Bignami3  \n1 Unit of Otorhinolaryngology, Presidio Ospedaliero “Mons. Dimiccoli”, Barletta, Italy; 2 Unit of Otorhinolaryngology, Policlinico di Bari, Italy; 3 Unit of Otorhinolaryngology, ASST-Sette Laghi, University of Insubria, Varese, Italy; 4 Unit of Otorhinolaryngology, ASSTLariana, University of Como, Italy  \nSUMMARY  \nA literature review was conducted to assess the role of minimally-invasive endoscopic treatments for lacrimal pathway neoplasms. The study involved the analysis of 316 patients with benign or malignant tumours affecting the lacrimal drainage system. Histologically, the analysis revealed a prevalence of squamous cell carcinoma, followed by lymphatic neoplasms and melanomas. In terms of treatment, minimally-invasive endoscopic approaches, such as endoscopic dacryocystorhinostomy, play a predominant role in managing earlystage tumours, rather than merely obtaining samples for histological analysis. For more extensive tumours, which constitute the majority of cases, more aggressive external approaches are required, along with the use of adjuvant radiotherapy and chemotherapy. The lack of universally shared staging systems poses a limitation in standardisation and comparison of results. Treatment of these tumours remains complex due to their rarity and histological heterogeneity. A multidisciplinary approach is mandatory to optimise outcomes.  \nKEYWORDS: lacrimal drainage system, lacrimal pathway, tumours, endoscopic treatment, dacryocystorhinostomy, review  \nIntroduction  \nTumours ofthe lacrimal sac can be classified as primary, secondary, or metastatic. The latter involve the lacrimal pathways through direct extension by contiguity, predominantly originating from the orbital and nasal cavities, rather than through distant haematogenous spread. These are rare conditions that are mostly treated like primary tumours. Similarly, primary tumours of the lacrimal sac are rare: malignancies account for approximately 72% of cases, demonstrating local invasiveness and high recurrence rate. Benign tumours tend to manifest in younger adults, while malignant tumours typically present in the fifth decade 1. Tumours of the lacrimal sac are classified into four main categories: epithelial (71-75%), mesenchymal (12-15%), and haematolymphoid (10-12%) . Epithelial tumours constitute the most prevalent group, with squamous papilloma, transitional papilloma, fibrous histiocytoma, oncocytoma, and solitary fibrous tumour/haemangiopericytoma being among the most frequent histotypes. The most common malignant tumours include squamous cell carcinoma (SCC), non-keratinising SCC, non-Hodgkin lymphoma, melanoma, and adenocarcinoma. SCC, the most common malignant epithelial tumour, accounts for 19-23% of all lacrimal sac tumours 1-5.  \nReceived: February 16, 2024  \nAccepted: March 6, 2024  \nCorrespondence  \nAlessandro Maselli del Giudice  \nE-mail: [ale.maselli@tiscali.it](ale.maselli@tiscali.it)  \nHow to cite this article: Campobasso G, Ragno MS, MondaA, et al. Exclusive or combined endoscopic approach to tumours ofthe lower lacrimal pathway: review of the literature. Acta Otorhinolaryngol Ital 2024;44(SUPPL.1):S67-S81 . [https://doi.org/10.14639/0392-100X-suppl.1-44-](https://doi.org/10.14639/0392-100X-suppl.1-44-)[ ](https://doi.org/10.14639/0392-100X-suppl.1-44-)[2024-N2966](2024-N2966)  \n© Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale  \n OPEN ACCESS  \nThis is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attrib","cbCaiigkrpysONRm","https://ap.wps.com/l/cbCaiigkrpysONRm","pdf",894052,15,"English","# Summary\n# Introduction\n## Classification and histology of lacrimal sac tumours\n## Clinical presentation and diagnostic workup\n# Treatment approaches","[{\"question\":\"What was the purpose and scope of the literature review?\",\"answer\":\"To assess the role of minimally invasive endoscopic treatments for lacrimal pathway neoplasms. It analyzed 316 patients with benign or malignant tumours of the lacrimal drainage system.\"},{\"question\":\"Which tumours were most common based on histologic findings?\",\"answer\":\"Squamous cell carcinoma was the most prevalent, followed by lymphatic neoplasms and melanomas.\"},{\"question\":\"How do treatment strategies differ between early-stage and more extensive tumours?\",\"answer\":\"For early-stage tumours confined to the lacrimal fossa, minimally invasive endoscopic approaches such as endoscopic dacryocystorhinostomy are emphasized. For more extensive tumours, more aggressive external approaches are required, typically with adjuvant radiotherapy and chemotherapy.\"}]","Exclusive or combined endoscopic approach to tumours of the lower lacrimal pathway - review of the literature | PDF",1790040932,38]