Case study: Dacryocystomucopyocele
A 42-year-old male, came to Out Patient Department (OPD) with complaint of progressive swelling in the right eye inner corner since one and half years. He gave history of multiple episodes of painless increase in size of the swelling followed by spontaneous rupture with drainage of pus and some reduction in size. However, it was soon followed by gradual increase to present size. Last such episode was two months before presentation. Incision and drainage of the swelling was done elsewhere, 15 months back. There was no history of watering, redness, purulent discharge from the right eye. He also complained of some restriction in right nasal field since last few days. The patient denied any history of repeated attacks of sinusitis, rhinitis or pharyngitis. Systemic history was insignificant.
Chronic dacryocystitis is frequently caused by Nasolacrimal Duct (NLD) infection or obstruction. Mucocele is formed when chronic stagnation of tears occurs in the lacrimal sac. When mucocoele gets infected with pyogenic organisms, pyocele is formed. Proximal obstruction in mucopyocele causing encysted dacryocystomucopyocele presenting as an enormous swelling is very uncommon. Very few cases of giant encysted dacryocystomucopyocele are reported in literature. Hereby, authors report a case of 42-year-old male with an acquired, enormous dacryocystomucopyocele, which developed over only one and half years and produced upward displacement of the lower lid and mechanical obstruction for eye closure. Computed Tomography (CT) of orbit and paranasal sinuses was done to confirm the diagnosis and find out the extent of cyst. Complete surgical excision of the cyst was performed. There was no recurrence of the swelling at one year follow-up.
Ref: Journal of clinical and diagnostic Research