Acquired lacrimal sac fistula mimicking basal cell carcinoma

Litwin, Andre; Timlin, Hannah; Sagili, Suresh; Wright, Mandy Warthan; Malhotra, Raman

doi:10.1111/bjd.12244

Cited by 3 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Litwin et al . 31 described three patients with acquired lacrimal sac fistula, originally misdiagnosed as BCC. History of epiphora, discharge, preceding dacryocystitis, and positive syringing test helped confirm the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…The relatively long duration of the swelling, negative ROPLAS, the plane of lesion, and free mobility of the swelling raised suspicion of an alternative diagnosis. Litwin et al 31 described three patients with acquired lacrimal sac fistula, originally misdiagnosed as BCC. History of epiphora, discharge, preceding dacryocystitis, and positive syringing test helped confirm the diagnosis.…”

Section: Skin and Subcutaneous Massesmentioning

confidence: 99%

See 1 more Smart Citation

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

Diab

Ali

Mohammed

2022

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose Several non-lacrimal lesions can present with lacrimal sac area swelling mimicking a dacryocystocele or mucocele with a possibility of misdiagnosis. This study investigates the clinic-radiologic characteristics of the mimicking conditions compared to true lacrimal sac distension. Design Retrospective, comparative, interventional case series Participants Patients referred by primary care ophthalmologists between January 2015 and October 2021 with a misdiagnosis of dacryocystocele or lacrimal sac mucocele (n = 39) and an age-matched group of proven true lacrimal sac swelling (TLS group, n = 44). Methods Data collected included demographics, presenting features, investigations, management, histopathology, and outcomes. Both groups were statistically compared for several clinical and radiological variables. Results Final diagnoses in the mimicking group were skin/subcutaneous swellings (14/39, 35.9%), vascular malformations (10/39, 25.6%), inferomedial anterior orbital cysts (7/39, 17.9%), sino-orbital masses (5/39, 12.8%). Female gender (<0.001), epiphora (p = 0.001), and discharge (p < 0.001) were significantly more frequent in the TLS group. The mimicking group was more likely to be associated with a longer swelling duration (p < 0.001), a swelling extending beyond the lacrimal sac area (p <0.001), orbital signs (p <0.001), and periorbital abnormality. Non-patent lacrimal irrigation (p < 0.001) was significantly more frequent in the TLS group. On imaging, all swellings in the mimicking group were separate from the lacrimal pathway and 94.9% (37/39) extended beyond the lacrimal sac fossa. Conclusion Various cutaneous, subcutaneous, vascular, inferomedial orbital cystic, and sinonasal pathologies can present with lacrimal sac area swelling and mimic a TLS. A high index of suspicion, a thorough clinical evaluation and proper imaging are essential to avoid a misdiagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Skin and Subcutaneous Massesmentioning

confidence: 99%

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

Diab

Ali

Mohammed

2022

European Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

The Orbit, Including the Lacrimal Gland and Lacrimal Drainage System

Verdijk

Pecorella

Mooy³

2014

Eye Pathology

View full text Add to dashboard Cite

Congenital lacrimal fistula: A major review

Chaung

Sundar

Ali

2016

Orbit

View full text Add to dashboard Cite

The purpose of this article is to review and summarize the etiopathogenesis, symptomatology, systemic associations, management, complications and clinical outcomes of congenital lacrimal fistulae. The authors performed an electronic database (PubMed, MEDLINE, EMBASE and Cochrane Library) search of all articles published in English on congenital lacrimal fistulae. Congenital subsets of patients from series of mixed lacrimal fistulae were included in the review. These articles were reviewed along with their relevant cross-references. Data reviewed included demographics, presentations, investigations, management, complications and outcomes. The prevalence of congenital lacrimal fistulae is reported to be around 1 in 2000 live births. They are frequently unilateral, although familial cases tend to be bilateral. Lacrimal and systemic anomalies have been associated with lacrimal fistulae. Exact etiopathogenesis is unknown but mostly believed to be an accessory out budding from the lacrimal drainage system during embryogenesis. Treatment is indicated when significant epiphora or discharge is present and is mostly achieved by various fistulectomy techniques with or without a dacryocystorhinostomy. Congenital lacrimal fistulae are a distinct clinical entity with unique features. Surgical management can be challenging and successful outcomes are usually achieved with widely accepted protocols.

show abstract

Acquired lacrimal sac fistula mimicking basal cell carcinoma

Abstract: These cases illustrate the importance of questioning patients about their previous ocular symptoms when dealing with less familiar periocular lesions.

Cited by 3 publications

References 9 publications

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

The Orbit, Including the Lacrimal Gland and Lacrimal Drainage System

Congenital lacrimal fistula: A major review

Contact Info

Product

Resources

About