Idiopathic acquired dacryocystocele treated with endonasal endoscopic dacryocystorhinostomy

Abstract

A 64-year-old woman presented with a medial canthal mass in her left eye, which was accompanied only by mild epiphora. There was no history of dacryocystitis, bloody tears, midfacial trauma or surgery. Physical examination showed a non-inflammatory, subcutaneous, immobile mass below the level of the medial canthal tendon. Lacrimal irrigation demonstrated blockage at the nasolacrimal duct. A CT revealed a non-enhancing, low density, cystic lesion in the inferomedial aspect of the left orbit without bony erosion, which was compatible with an idiopathic acquired dacryocystocele. The patient underwent endonasal endoscopic dacryocystorhinostomy (DCR) and silicone intubation. Epiphora resolved immediately after surgery. Two years after surgery, the patient has had no recurrence of either the epiphora or the orbital. Idiopathic acquired dacryocystocele associated only with epiphora without accompanying dacryocystitis although rare should be considered in the differential diagnosis of acquired non-inflammatory medial canthal masses. Endonasal endoscopic DCR represents a safe and effective treatment.

Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

“…Similarly, nasolacrimal duct cysts and dacryoceles are considered congenital abnormalities of the NLD, and are usually diagnosed early in infancy. Such pathologies are possibly more common in adults than previously thought, as seen in our series and some other recent publications [3][4][5][6][7]. Dacryoliths (Fig.…”

“…Three cysts, three obstructive membranes, two severe septal deviations, two concheal hypertrophies, and two dacryoliths. To date, no large series reported dacryoliths and membranes obstructing the IM and previous reports of other IM pathologies were confined to case reports [3][4][5][6][7][8].…”

Idiopathic Acquired Dacryocystocele Presenting Only with Epiphora: A Very Rare Case Report

“…Epiphora as the only symptom without accompanying dacryocystitis is very rare. Only five cases of idiopathic acquired dacryocystocele with only associated epiphora have been previously reported [ 3 - 8 ].…”

“…Idiopathic acquired dacryocystocele with only epiphora and without any associated dacryocystitis is a very rare disease. Only five cases have been previously discussed [ 3 - 8 ]. We are presenting another case of idiopathic acquired dacryocystocele associated only with epiphora.…”

Foreign body mimicking malignancy in acquired dacryocystocele

“…In most cases, dacryocystoceles transpire congenitally while only few cases have been reported for the acquired form . Many underlying etiologies have been associated with acquired dacryocystoceles including severe inflammation, surgery, radiation therapy, and also malignant tumors originating from medial canthal or sinonasal regions disrupting the nasolacrimal duct and causing dacryocystocele .…”