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Introduction: Fewer than 250 primary tumors of the lacrimal duct have been reported in the international literature. Because their signs and symptoms are nonspecific and usually subclinical, delayed diagnosis is common. Treatment for malignant epithelial tumors is surgical, with or without radiation., Patients and Methods: The present study is a retrospective analysis of five patients with malignant lacrimal duct tumors., Results: Three patients were diagnosed with carcinoma requiring wide en bloc surgical resection with surgical reconstruction. One underwent adjuvant radiation therapy. Another experienced simultaneous local and lymph node recurrence after 3 years and underwent curative surgery. Two additional patients were diagnosed with diffuse malignant large B-cell non-Hodgkins lymphoma., Discussion: Early symptoms of lacrimal duct tumors are nonspecific and mimic acute dacryocystitis. Lacrimal system CT, MRI and rhinoscopy may allow for earlier diagnosis. Surgical treatment requires resection with wide margins and reconstruction of the medial canthal region., Conclusion: Only an early diagnosis can reduce the impairment related to surgery and the extent of the required reconstruction, as well as improve survival., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

We report a series of 174 percutaneous gastrostomies implanted in our interventional radiology unit in patients with cancer of the upper airway and upper digestive tract: two localizations, hypopharynx and oropharynx comprised 68% of the cases (106/174). Tumor stage had reached palliative treatment in 80 cases, was in the initial phase of treatment in 57 cases and was in a sequelae phase after treatment in 37 cases. Despite problems related to anatomic modifications and tumor volume or sequelae of prior or ongoing treatment, we did not record any failures. The rate of minor complications was 15%. The one severe complication (peritonitis) required laparotomy. The duration of enteral nutrition via the gastrostomy varied from 3 weeks to more than 3 years. There were no long-term complications. We thus suggest that interventional percutaneous gastrostomy is a useful alternative to endoscopic percutaneous gastrostomy or the nasoesophageal tube, particularly in patients with voluminous tumors restricting the hypopharynx and oropharynx.

Among the various procedures of pharyngeal reconstruction after circumferential pharyngolaryngectomy, the free jejunal autograft (FJA) has become a common one. We retrospectively reviewed 73 cases of reconstruction with FJA after resection for advanced hypopharyngeal carcinomas (70 primary reconstructions, 3 secondary reconstructions). Postoperative outcome, functional and carcinologic results were studied. There were 1 postoperative death, medical complications in 19 patients, 4 graft failures (5.5%), 11 salivary fistulas. The nasogastric tube was removed before the 15th day in more than a half of the patients. One year postoperatively all the evaluable patients were able to take an oral diet (solid or soft diet for 97% of them). The postoperative radiotherapy was well tolerated. Cancer developed further in 33 patients (13 local and/or nodal recurrences, 13 isolated metastasis, 7 second primaries). The overall survival rate was 44.8% at three years. It seems clear that FJA allows good functional results and increases the quality of life in such patients with poor prognosis.