Tumors of the Lacrimal Drainage System: Diagnosis and Management

Tumors of the lacrimal drainage system are rare and include benign and malignant variants. Their presentation frequently mimics inflammatory or obstructive lacrimal disease, which often results in delayed diagnosis and diagnostic uncertainty. A high index of suspicion, appropriate imaging, and timely biopsy are required to verify the histology and guide management. Surgical excision remains the cornerstone of treatment for most lesions, with the aim of achieving histologically clear margins. Advances in endoscopic and combined surgical approaches have enabled radical tumor resection whilst reducing morbidity and improving globe preservation. Adjuvant radiotherapy is commonly employed in malignant disease, while systemic chemotherapy, immunotherapy, and targeted therapies may be considered in selected advanced or recurrent cases. Emerging molecular insights and evolving surgical techniques may further refine future treatment strategies. This review summarizes current evidence and clinical principles to provide a practical framework for the diagnosis and management of lacrimal drainage system tumors.