Fibrous Dysplasia-like Tumor of the Lacrimal Sac

Scott, Geraldine; Frueh, Bartley R.; Flint, Andrew; Elner, Victor M.

doi:10.1097/iop.0b013e3181853645

Ophthalmic Plastic &Amp; Reconstructive Surgery

2008

DOI: 10.1097/iop.0b013e3181853645

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Fibrous Dysplasia-like Tumor of the Lacrimal Sac

Geraldine Scott

Bartley R. Frueh

Andrew Flint³

et al.

Abstract: A 75-year-old woman developed epiphora and a slowly enlarging right medial canthal mass for 1 year. CT revealed a mass with ground-glass radiodensity and hazy borders in the lacrimal sac. At external dacryocystorhinostomy, a tan, gritty, spherical mass was easily removed from the sac lumen. Histopathologic characteristics were typical of fibrous dysplasia. The postoperative course was uneventful.

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Cited by 5 publications

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“…To the best of our knowledge, no relevant studies on the subject have been reported in the literature to date. [1][2][3][4][5][6] Knowledge of the osseous appearance in this region could help radiologists and clinicians increase their awareness of the variant or asymptomatic FD, avoiding confusion with tumor or infection. For us, there has been some recent interest in the appearance of the frontal process of the maxilla.…”

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Fibrous Dysplasia-Like Appearance of the Frontal Process of the Maxilla on CT: Prevalence in North China

Yang¹,

Wang²,

Wang³

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY:The frontal process of the maxilla occasionally shows a localized FD-like appearance. The purpose of this study was to determine its prevalence and findings on CT. A retrospective study of 1000 consecutive paranasal sinus CT scans was preformed on outpatients without a history of trauma or previous surgery in our hospital during 6 months. CT images were interpreted independently by 2 experienced head and neck radiologists on a PACS system in a bone window setting. Of the 1000 patients (546 males; 454 females), 51 (5.1%,41 males and 10 females) had an FD-like appearance in the frontal process of the maxilla. There was a statistically significant difference between sexes (P Ͻ .001). Twenty-nine (56.9%) entities arose from the right frontal process and 22 (43.1%) from the left frontal process. These entities, with well-defined margins, were located at the base of the frontal process of the maxilla, appearing as an ovoid or triangular configuration on axial-plane CT and as a spindle or elliptic shape on the coronal plane. The mean maximal diameter was 9.8 mm (range, 3.6 -16.1 mm). These entities exhibited a pagetoid appearance (type I) in 37 (72.5%), a ground-glass appearance (type II) in 8 (15.7%), and a cyst-like appearance (type III) in 6 (11.8%) patients on CT. The FD-like appearance of the frontal process of the maxilla is not rare and can be readily detected by CT. ABBREVIATIONS: FD ϭ fibrous dysplasia During the past 10 years, we have incidentally encountered a few people with an FD-like appearance of the frontal process of the maxilla by paranasal sinus CT in our daily practice. These individuals usually presented to the ear, nose, and throat clinic with rhinosinusitis symptoms and underwent paranasal sinus CT scans. On the basis of outpatient medical records, they had no facial deformities on physical examination. To the best of our knowledge, no relevant studies on the subject have been reported in the literature to date.1-6 Knowledge of the osseous appearance in this region could help radiologists and clinicians increase their awareness of the variant or asymptomatic FD, avoiding confusion with tumor or infection. For us, there has been some recent interest in the appearance of the frontal process of the maxilla. This prompted our study to determine the prevalence and features of it on paranasal sinus CT scans of outpatients in North China. Materials and Methods PatientsThis study was approved by the institutional review board. A retrospective review of paranasal sinus CT scans of 1000 consecutive outpatients who were consecutively selected by a PACS system in our hospital between August 1, 2008, and January 31, 2009, was performed. All these patients were referred for CT due to clinical symptoms, presumably rhinosinusitis. Their clinical medical records were reviewed, and they had no history of trauma or prior surgery. CT TechniqueCT images were acquired in both the axial and coronal planes by using a Brilliance 64-section CT scanner (Philips Healthcare, Best, the Netherlands). The imaging parame...

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mentioning

confidence: 99%

Fibrous Dysplasia-Like Appearance of the Frontal Process of the Maxilla on CT: Prevalence in North China

Yang¹,

Wang²,

Wang³

et al. 2011

AJNR Am J Neuroradiol

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Unexpected pathologies in patients referred for endoscopic DCR

Golan

Leibovitch

Landsberg

2014

Eur Arch Otorhinolaryngol

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The objective of this study is to describe a series of patients with different pathologies mimicking nasolacrimal duct obstruction (NLDO), diagnosed with the use of a computed tomography (CT) scan prior to a scheduled endoscopic dacryocystorhinostomy (DCR). This study is a retrospective report. We reviewed the medical records of 47 consecutive patients (57 sides) with long-standing epiphora between 2007 and 2012. All patients were referred to our tertiary Medical Center with a diagnosis of NLDO and were expected to undergo endoscopic dacryocystorhinostomy (DCR). They all underwent routine sinus CT scan prior to surgery. All scans, as well as the demographic and medical characteristics of these patients were reviewed. Of all 47 patients enrolled, in 4 patients (7 % of all sides), unexpected pathologies, other than nasolacrimal system distention, inflammation or infection were identified preoperatively. These included squamous cell carcinoma of the lacrimal sac and nasolacrimal duct, rhinoscleroma at Hasner's valve region, a compressing ethmoidal mucocele and a case of dacryocystocele. These unusual pathologies mandated a different management and surgical approach. In all four cases, a preoperative CT scan helped in identifying the pathology and in localizing the lacrimal apparatus in relation to the paranasal sinuses. Different nasal, paranasal and lacrimal pathologies may mimic primary acquired NLDO. A high index of suspicion, a thorough clinical evaluation and utilizing preoperative imaging may lead to an alteration of patient management and to a completely different surgical approach.

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Nasolacrimal duct tumours in the era of endoscopic dacryocystorhinostomy: literature review

2013

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Fibrous Dysplasia-like Tumor of the Lacrimal Sac

Cited by 5 publications

References 10 publications

Fibrous Dysplasia-Like Appearance of the Frontal Process of the Maxilla on CT: Prevalence in North China

Fibrous Dysplasia-Like Appearance of the Frontal Process of the Maxilla on CT: Prevalence in North China

Unexpected pathologies in patients referred for endoscopic DCR

Nasolacrimal duct tumours in the era of endoscopic dacryocystorhinostomy: literature review

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