Title : Sac swelling doesn’t regurge: No time to relax
Abstract:
Objective: Lacrimal sac tumors are extremely rare. Most common benign tumor being squamous papilloma. Herein we present two unusual cases of benign lacrimal sac tumors with aim to highlight their clinical features and diagnostic challenges.
Methods: Case report presenting clinico-demographic profile, histology and radiological data of two cases of lacrimal sac tumors.
Results: Two middle-aged women, aged 25 and 33 years, presented with complaint of painless, progressive swelling in the left inferomedial orbital region without any history of epiphora, epistaxis or hemolacrimia. Clinical examination revealed a firm, well-defined mass in the lacrimal sac area with superotemporal globe dystopia in both cases. CT-DCG/CECT revealed a mass in the lacrimal sac region. A provisional diagnosis of lacrimal sac tumor was made. Both patients underwent surgical excision with dacryocystectomy and histopathological evaluation confirmed a solitary fibrous tumor in one case and a neurofibroma in the other.
Conclusion: Benign tumors of the lacrimal sac such as SFT and neurofibroma are exceedingly rare and may mimic chronic dacryocystitis or mucocele. Benign lacrimal tumors may not produce epiphora; and clinical and radiological findings may not be conclusive with regard to the location of such large tumors (intra or peri sac). The best approach to management of such large tumors is intra-operative evaluation with prompt dacryocystectomy in cases with large sac tumors.
