Pyogenic granuloma of the lacrimal sac

BACKGROUND: Pyogenic granulomata belong to the group of inflammatory pseudotumours. They consist of granulation tissue usually following inflammatory processes or trauma. PATIENT: We report on a 86-year old female suffering from chronic dacryocystitis. In the course of the treatment exstirpation of the lacrimal sac was performed. The removed tissue was analysed histologically. RESULTS: Histological examination revealed a dense lymphoplasmacellular infiltration underlying the epithelium of the lacrimal sac. A mushroom-like tumour rising into the lumen of the lacrimal sac could be observed. This tumour consisted of capillaries and a dense inflammatory infiltrate. The findings were consistent with a pyogenic granuloma of the lacrimal sac. CONCLUSION: Pyogenic granulomata usually arise in the conjunctiva as a sequel of chronic lipogranulomatous inflammation. They are very rare in other areas such as the lacrimal drainage system.     

Pyogenic granuloma of the lacrimal sac

In this report, we describe three adult patients diagnosed with lacrimal sac pyogenic granuloma. The presenting symptoms were acute dacryocystitis, lacrimal mass, and bloody tears. The nasolacrimal drainage pathway was obstructed in all cases. Radiologic evaluation performed in one patient revealed the presence of a well-defined mass in the sac with homogenous contrast uptake. Histopathologic examination revealed capillary proliferation and inflammatory cells in a fibromyxoid stroma. The patients were followed up for 11–23 months after external dacryocystorhinostomy without recurrence of the tumor or nasolacrimal obstruction. Pyogenic granuloma may develop from the lacrimal sac mucosa and may cause bloody epiphora. Such a tumor is visualized as a hemorrhagic mass lesion, and it may not have a negative effect on the outcome of DCR.     

Squamous cell carcinoma of the lacrimal sac

The clinical and histopathological findings in a 40-year-old man with a lacrimal sac tumor are reported. Although the clinical history indicated a lacrimal sac obstruction and recurrent dacryocystitis, the lesion was diagnosed by light microscopy as a squamous cell carcinoma.     

Basal cell carcinoma in lacrimal sac

A 53-year-old woman was admitted to the hospital one year after the onset of her complaints. She suffered from epiphora and swelling in the lacrimal sac region. Biopsy revealed islets of classical basal cell carcinoma with peripheral formation of palisades within a hyperemic stroma. During surgery, the lacrimal drainage system and neighboring bony structures were completely excised. No local recurrences were detected on orbital tomography performed 6 and 15 months postoperatively. As far as the authors know, this is the first case of basal cell carcinoma in the lacrimal sac reported in the literature.     

Hemangiopericytoma of the lacrimal sac

Hemangiopericytomas of the orbit are rare tumors with low malignancy potential. To the authors' knowledge, only three previous cases of these tumors occurring in the lacrimal sac have been reported. The authors report a fourth case. Follow-up was obtained on the first reported case, and the patient in that case had a recurrence after 15 years. These tumors should be totally excised and followed for long periods of time.     

Haemangiopericytoma of the lacrimal sac

Haemangiopericytomas (HPCs) are rare tumours which infrequently occur in the lacrimal sac. Only 8 cases of lacrimal sac HPC have previously been reported. The authors report 2 additional cases presenting clinically with epiphora and a mass. One case recurred 3 times during an 18-year period. The other case did not recur during 51 months of follow-up. The tumours showed immunohistochemical features consistent with a diagnosis of HPC. The authors recommend wide excision for these tumours and careful long-term follow-up to detect recurrence which is not uncommon.     

Neurofibroma of the lacrimal sac

Neurofibroma is an extremely rare neural tumor of the lacrimal sac. We present a case of neurofibroma of the lacrimal sac in a 45-year-old lady. Based on the history of intermittent epiphora, presence of a mass in the lacrimal sac region, dacryocystogram suggestive of space occupying lesion within the lacrimal sac and computed tomographic image of a tumor lying in the lacrimal fossa region, a tentative diagnosis of lacrimal sac neoplasm was made. Excision of the tumor with repair of the lacrimal sac was performed. Histopathology proved it to be neurofibroma of the lacrimal sac. Until now, only four cases have been reported worldwide. The paucity of reported cases limits our knowledge regarding the natural course, treatment, results and prognosis of this tumor.     

Argyrosis of the lacrimal sac

Silver deposition in the wall of the lacrimal sac after prolonged application of mild silver protein (Argyrol) eye drops is documented at the light and electron microscopical level. Silver granules were found in the extracellular matrix predominantly on elastic fibres and within cells forming conglomerates in secondary lysosomes. Most of the silver-containing cells showed a prominent rough endoplasmic reticulum, suggesting their fibroblastic origin. Investigation by energy-dispersive analysis of X-rays (EDAX) indicated the precipitation of silver as selenide.     

anastomosis lacrimal sac conjunctival sac in severe laceration of lacrimal canaliculus

PURPOSE:To investigate the clinical effect of anastomosis lacrimal sac conjunctival sac in the treatment of severe laceration of lacrimal canaliculus. METHODS:A total of 19 cases (19 eyes) with laceration of lacrimal canaliculus underwent anastomosis lacrimal sac conjunctival sac.All the patients were followed up for 3 to 24 months postoperatively. RESULTS:Among all the 19 patients (19 eyes), 14 cases were cured,3 cases wre markedly improved and 2 cases had no effect,and the effect rate was 89.47%. CONCLUSION:Anastomosis lacrimal sac conjunctival sac is an effective surgical technique in the management of severe laceration of lacrimal canaliculus.