A 25-year-old man presented with a mass on the right medial canthus after a successful dacryo cys torhinostomy performed 3 years ago. On examination, there was a firm, nondepressible mass inferior to the medial canthal ligament and a linear vertical scar on the lateral wall of the nose. Syringing through the right lower punctum indicated his lacrimal system was patent. Computed tomography and magnetic resonance imaging disclosed a large cystic lesion in the lacrimal sac fossa. No bone erosion was detected. The mass was approached through a tear trough incision and completely resected. The lacrimal anastomosis that was highly placed remained patent after surgery. Histopathology of the specimen revealed a cystic lesion compatible with lacrimal origin (dacryocystocele).
Dacryocystocele may be a complication of highly placed external dacryocystorhinostomy.
*Department of Ophthalmology, Complejo Asistencial Palencia, Palencia, Spain; †King Khaled Eye Specialist Hospital, Ryiadh, Saudi Arabia; ‡Oculoplastics and Orbit Division; §Diagnostic and Imaging Department; ‖Department of Pathology and Laboratory Medicine; ¶Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto–University of São Paulo, São Paulo, Brazil; and #Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, U.S.A.
Accepted for publication August 16, 2014.
The authors have no financial or conflicts of interest to disclose.
Address correspondence and reprint requests to Antonio A.V. Cruz, M.D., Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. E-mail: firstname.lastname@example.org