Lacrimal ductal cyst of the medial orbit: a case report
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CASE REPORT
Open Access
Lacrimal ductal cyst of the medial orbit: a case report Yu Zhang, Changhong Zeng, Ningshao Chen and Chunling Liu*
Abstract Background: The lacrimal ductal cyst (dacryops) is an uncommon clinical entity. It occurs anywhere that lacrimal gland tissue is present but most often appears as an expanding mass in the region of the lacrimal gland. The presence involving the medial part of the orbit is rare, ectopic location can be misleading in the differential diagnosis of orbital masses. The authors report a 53-year-old man who presented with dacryops occurred in an unusual location with significant clinical presentations. Case presentation: A 53-year-old man had a painless mass located in the right superomedial orbit accompanied with foreign body sensation and lachrymation for two months, which had rapidly grown within 10 days. Decrease of visual acuity, high intraocular pressure (IOP) and limitation of extraocular movements in the right eye were present. The result of visual evoked potential (VEP) test suggested the impaired function of the optic nerve. Magnetic resonance imaging (MRI) studies revealed the presence of an isolated cystic lesion. The mass was completely removed via a transcutaneous approach, histopathologic findings were consistent with the lacrimal ductal cyst. The ocular motility and high IOP returned to normal. There had been no post-operative complications or signs of recurrence over five months follow-up. Conclusion: Lacrimal ductal cysts can present in the medial orbit, clinicians should include this entity in the differential diagnosis of orbital masses and be aware of its variable presentations such as high IOP in this case. We comment on the fact that many reported cases of ectopic dacryops may be an extension of normal lacrimal gland tissue. Keywords: Lacrimal ductal cyst , Dacryops, Intraorbital mass, Intraocular pressure
Background The lacrimal ductal cyst (dacryops) is a benign epithelial tumor of the lacrimal tissue, which usually locates in the outer part of the upper eyelid presenting to be an asymptomatic, smooth, mobile and fluctuant swelling [1]. Ectopic dacryops is lacrimal ductal cyst located at any site other than the normal. The presence involving the medial part of the orbit is very rare [1–4]. These cysts may cause mechanical blepharoptosis, proptosis, mechanical restriction of the ocular motility and diplopia [5, 6]. Secondary high intraocular pressure due to * Correspondence: [email protected] Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People’s Republic of China
dacryops has not been reported previously. Herein, the authors report a case of ectopic dacryops in the medial orbit.
Case presentation A 53-year-old man complained of a painless swelling of the right upper lid for 2 months accompanied with foreign body sensation and lachrymation. The mass had rapidly developed within 10 days, which could be enlarged and purplish blue after rubbing the eye. The patient denied the history of trauma, infectio
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