Human Papillomavirus and Mucoepidermoid Carcinoma of the Lacrimal Sac: Histopathology, Pathophysiology, and Natural History

Abstract

Abstract: : Purpose: To examine the histopathology, pathophysiology, and natural history of mucoepidermoid carcinoma of the lacrimal sac and its correlation with human papillomavirus (HPV). Methods: Histopathology, pathophysiology, natural history, and HPV status by in–situ hybirdization are examined for a patient with mucoepidermoid carcinoma of the lacrimal sac and are compared with the only ten reported cases. Results: Comparison of our specimen with previously reported cases revels mass and epiphora as common findings in the natural history of this condition. HPV has been demonstrated in mucoepidermoid carcinoma of the cervix but has not been reported in mucoepidermoid carcinoma of the lacrimal sac. Histologic sections demonstrate a papillomatous epithelial proliferation lining the lacrimal sac with an invasive component exhibiting both squamous and mucin–containing epithelial differentiation. Histochemical staining with mucicarmine confirms the presence of intracytoplasmic mucin within neoplastic cells. HPV is demonstrated within the neoplastic epithelium. Histopathologic findings, including the histological grade, may suggest the natural history and treatment of this extremely rare condition. Conclusions: Mucoepidermoid carcinoma of the lacrimal sac is an extremely rare type of carcinoma which may be associated with HPV. We report the first such case involving the lacrimal sac that is associated with HPV.

Keywords: tumors • pathology: human • lacrimal gland