Adenoid cystic carcinoma in the nasolacrimal duct: a case report.

Adenoid cystic carcinoma (ACC) rarely occurs in the nasolacrimal duct (NLD), and when it does, it has nonspecific manifestations. To the best of our knowledge, one case of ACC in the NLD has been reported in the literature. Herein, we report a second case of ACC in the left NLD, concerning a man in his late 60s. He presented with epiphora, and swelling and pain below the left medial canthus. Nasal endoscopy revealed bulging of the lateral wall in the left nasal cavity, with an intact nasal mucosa. Paranasal sinus computed tomography showed an enhancing mass at the epicenter of the left NLD, involving the maxillary sinus, inferior turbinate, and nasal cavity, with bony destruction. The patient underwent superomedial maxillectomy. The pathology was high-grade ACC. Despite undergoing five rounds of postoperative radiotherapy, the ACC recurred 11 months after the operation. Early identification is critical for reducing the morbidity and mortality of patients with ACC in the NLD.