# Lacrimal Sac Tumors: A Histotype-Driven Literature Review

## TL;DR

This paper reviews lacrimal sac tumors, highlighting their rarity, diagnostic challenges, and the need for multidisciplinary treatment approaches.

## Contribution

The paper provides a histotype-driven literature review and emphasizes the need for a standardized staging system and multi-institutional research.

## Key findings

- Lacrimal sac tumors have diverse histologies and lack a standardized staging system.
- Endoscopic resection is feasible only in limited cases of non-aggressive tumors.
- Multidisciplinary collaboration is essential for effective diagnosis and treatment.

## Abstract

Lacrimal sac tumors are represented by a large array of benign and malignant histologies. Because of their rarity, diagnosis is usually delayed and the management remains unclear. Improvements in imaging and transnasal endoscopy have brought practical innovations for these lesions that need a multidisciplinary expertise from head and neck surgeons to ophthalmologists. Establishing a commonly accepted staging system is a priority for these tumors, while surgical resection also with the aid of endoscopy remains the cornerstone of treatment. Future multi institutional registries are fundamental for strengthening the evidence in this field.

Objectives: Because of their rarity, lacrimal sac tumors (LSTs) are challenging to diagnose and treat. We herein provide an overview of the recent literature. Methods: A scoping search of the Cochrane library, PubMed and Google Scholar database in the last 5 years was conducted. Three independent reviewers extracted data, and the findings were summarized due to study heterogeneity. Results: A total of 55 articles were included. LST histology is diverse and there is no commonly accepted staging system. Recent discoveries in their biology are offering new treatment strategies but exclusive endoscopic resections remain feasible in only very limited cases of non-aggressive LSTs. Conclusion: LSTs require a high index of suspicion because of their rarity. A histotype-driven treatment plan must be carefully prepared, but complete excision remains the cornerstone of treatment in all cases.