Asymptomatic Lacrimal Ductule Dacryolithiasis with Embedded Cilia

Abstract

We describe a case of a 32-year-old man who presented with a visually apparent but otherwise asymptomatic mass in the right lateral fornix. Computerized tomography demonstrated the mass adjacent to the lacrimal gland. The mass was surgically removed, and histopathologic examination was consistent with a dacryolith of the lacrimal ductule. There were several cilia isolated from the dacryolith. This entity should be considered in the differential diagnosis of patients presenting with a localized mass in the region of the lacrimal gland.

Stones in the lacrimal gland: a rare condition

“…Our patients healed without postoperative complications. Similar results have been described previously (Baker & Bartley 1990;Zafar et al 2004).…”

“…Stones (dacryoliths) in the lacrimal drainage system are relatively common (Marthin et al 2005), whereas stones in the lacrimal gland are very rare and very few have been published (Naito et al 1973;Duke-Elder 1974;Baker & Bartley 1990;Baratz et al 1991;Mawn et al 1997;Zafar et al 2004). Woman are significantly more prone to developing stones in the lacrimal drainage system than men (Andreou & Rose 2002); it is therefore noteworthy that all three of our subjects were men.…”

“…Lacrimal gland stones may be totally asymptomatic (Zafar et al 2004). Symptoms described comprise unilateral conjunctivitis with discharge and epiphora (Baker & Bartley 1990), and pain and photophobia have also been noted (Duke-Elder 1974;Baker & Bartley 1990).…”

“…There have been many reports of stones in the canalicles, nasolacrimal duct and nasolacrimal sac (Marthin et al 2005). Stones in the lacrimal gland itself are, however, very unusual and only nine cases have been reported (Naito et al 1973;DukeElder 1974;Baker & Bartley 1990;Baratz et al 1991;Mawn et al 1997;Zafar et al 2004). The spontaneous cause of this condition is not known.…”

Dacryoliths in the lacrimal gland ductule

“…Twelve cases of dacryoliths in the lacrimal gland have been reported (Naito et al 1973;Duke-Elder 1952;Baker & Bartley 1990;Baratz et al 1991;Mawn et al 1997;Zafar et al 2004;Halborg et al 2009). …”