All for Life
Rare Lacrimal Sac Cancer
A patient suffering from a very rare type of cancer – lacrimal sac cancer tumour – has been successfully operated at Wellkin Hospital a few days ago. The tumour was removed while preserving the eye of the patient. Dr Dinesh Murmu, Senior Consultant ENT, Head and Neck Surgery, gives us more details about this complex case.
Dr Murmu says that we all have tear gland called lacrimal gland in both the eyes. The tears are essential to keep our eyes moist and this prevents dryness in our eyes and protects our eyes from external irritants and infections. He explains that tears are produced by the lacrimal gland and then are collected in the lacrimal sac (the tears storing sac).
“In the case of this patient, the cancerous tumour had developed into the lacrimal sac. This is a very rare type of cancer. So far, there are only about 775 known cases reported worldwide”, Dr Murmu says.
The Consultant and his team at Wellkin Hospital came to know about this particular case through Dr Ashwamed Dinassing (Consultant ENT) who initially operated the patient to unblock the lacrimal sac as the tears were flowing out through his affected eye without being absorbed or drained through his nose. He did not have any other symptom like pain or headache.
While performing the surgery, Dr Dinassing noticed that there was a suspicious growth inside the lacrimal sac. He did a biopsy which revealed that the tumour was cancerous.
So, both Dr Dinassing and Dr Murmu had to do the surgery together as this was a complicated case. The tumour was very close to the left eye of the patient who is in his fifties. It was going into the sinus. It was therefore involving the left eye, the orbit and the sinus.
“We had to remove a part of the floor of the left eye, the lacrimal sac and part of the maxillary sinus. The tumour was getting very close to the eyeball and the optic nerve that is responsible for vision. However, as the patient has a good vision, we wanted to spare the eye with its vision. Fortunately, we were able to remove the tumour while preserving the eyeball through a very delicate and difficult five-hour surgery using microscope and endoscope. The patient was worried, especially when we told him that when he would be operated, he might lose his eye or vision. So, he was really surprised after the surgery to see that his vision was still there. He was very happy and grateful,” says Dr Murmu.
The patient recovered very well after the surgery. He did not have to be admitted in the ICU. He was able to go home five days later.
Dr Murmu adds that it is the very first case of lacrimal sac cancerous tumour in Mauritius and it is an extremely rare type of cancer and the main cause is still unknown to medical experts.
What next for the patient? He will probably need chemotherapy and radiotherapy treatments once the wound heals and that is about six weeks after the surgery.
ENT, Head and Neck Tumours are manageable in Mauritius
The ENT, Head and Neck Surgeons have the required expertise to manage various head and neck tumours in Mauritius. Therefore, in most of the cases there is no need for the patients to go abroad for medical treatment. “Most of such patients would probably go abroad for treatment for such types of tumours despite the cost. The plane ticket itself is expensive. Then you must bear all sorts of expenses. For example, the medical treatment itself but also accommodation for the relative who accompanies the patient. They will both need to stay there for at least one month for the medical follow-up. So, the cost of the treatment is very high. Therefore, it is important for the patients, primary physicians and referring doctors, to know that head and neck cancers can be treated in Mauritius”, Dr Murmu points out.
ENT, Head & Neck cancers involve Ears, Nose, Throat, Neck, Thyroid, Oral Cavity and Nasal Sinuses cancers, which in turn involve the eye and the Brain, “Sometimes people are clueless and helpless about where to go, how to and whom to approach. We want them to know that we are here to help and treat them and this is very cost effective for them. The patient does not need to leave his country to be treated and can still rely on the physical presence of his family to support him. And we are here at any point in time to give him full medical support,” adds Dr Murmu.