Simple Dacryops: A Case Series and Review of the Literature

Abstract

In this prospective, small case series, 3 patients with simple dacryops were analyzed along with a review of literature. All 3 patients in this series had classical clinical features of simple dacryops. All of them underwent complete cyst removal with the aid of a cryoprobe. Histopathology was compatible with dacryops. In 2 of the 3 patients, the cyst revealed calcification, which to the best of our knowledge has not been reported. None of the patients developed a recurrence. In conclusion, simple dacryops is an easily recognized clinical entity. This entity has been infrequently reviewed in the older literature, and in the last decade only 6 cases have been reported. Most of the patients underwent complete excision of the cyst with no recurrences.

Characterization of Dacryops Infections

“…They appear smooth-walled and bluish-gray and tend to transilluminate, helping differentiate their cystic nature from solid masses. [1][2][3][4][5] This is an important distinction to help rule out a neoplasm, which may necessitate imaging such as U/S or CT 8 in cases where chronic dacryops may be associated with an underlying tumor 9,10 or malignancy. 11 CT has the added benefit of ruling out features concerning for malignancy such as bony involvement, poorly differentiated cystic changes, or poorly encapsulated lesions.…”

“…(Ophthal Plast Reconstr Surg 2015;31:58-62) L acrimal gland ductal cysts (dacryops) are a rarely reported consideration in the differential diagnosis of ocular adnexal lesions. [1][2][3][4][5] Typically, they present at the superotemporal eyelid fornix where the most lacrimal gland tissue is present; however, the accessory glands of Wolfring and Krause or choristomatous lacrimal gland tissue may also be susceptible. 1,4,5 They account for up to 2% to 9% of lacrimal gland lesions.…”

“…[1][2][3][4][5] Typically, they present at the superotemporal eyelid fornix where the most lacrimal gland tissue is present; however, the accessory glands of Wolfring and Krause or choristomatous lacrimal gland tissue may also be susceptible. 1,4,5 They account for up to 2% to 9% of lacrimal gland lesions. 1,6 Usually passive and slow-growing, they can show rapid growth in the context of infection, which is even more rarely reported in the literature.…”

Marsupialization for Lacrimal Ductular Cysts (Dacryops)

“…The proposed mechanism is either from preexisting lacrimal ductular cysts with areas of squamous metaplasia or less commonly from a choristomatous epithelial-lined cyst of the lacrimal gland. 12 Many treatment modalities have been proposed. 12 Patient 1 in our series developed a dacryolith in the cyst cavity.…”

“…The procedure is simple and technically less tedious and less timeconsuming in that it does not require vigilant dissection of cyst wall, and since it does not require orbitotomy, 12 it can be performed under local anesthetic even where there is deeper tissue involvement. This entails "deroofing" of the cyst wall and is a less invasive technique than excision.…”