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Abstract ID: 24-156

Novel interstitial brachytherapy treatment for lacrimal sac squamous cell carcinoma

Kadi Palumaa


We present a novel method with interstitial high dose rate (HDR) brachytherapy to treat residual lacrimal sac squamous cell carcinoma (SCC).


A case report is presented. A 61-year-old female presented with a complaint of watery left eye for 3 years. A lacrimal sac mass was discovered and removed. The histology showed a rare lacrimal sac p16-positive SCC with R1 resection. Therefore, additional adjuvant radiotherapy was needed, and a novel treatment method with interstitial brachytherapy was chosen.


HDR brachytherapy is a radiotherapy method that utilizes high-dose-rate radioactive isotopes (Ir192) to treat tumors in different regions, including the head and neck area. It allows the sparing of surrounding tissues and delivers high doses to limited tumor volume. To optimally cover the high-risk clinical target volume (tumor bed, nasolacrimal duct area, and caruncula) with radiotherapy, three 6F plastic catheters were inserted in the tumor bed. The patient tolerated the procedures well. The last MRI four months later did not show any disease recurrence, but the follow-up will continue.


Lacrimal sac tumors are mostly epithelial, of which about 75% are malignant. All patients need lifelong follow-up for recurrence and metastases as they can occur many years later and be fatal. Interstitial brachytherapy is a novel treatment option that can be used to treat residual smaller neoplasms in head-neck region, including the lacrimal system area.

Additional Authors

Reili Rebane – East Tallinn Central Hospital Eye Clinic

Margit Valgma – North Estonia Medical Centre Foundation

Artur Klett – East Tallinn Central Hospital Eye Clinic