Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030 , USA.
Ophthalmic Plast Reconstr Surg. 2012 Jul-Aug;28(4):e95-6. doi: 10.1097/IOP.0b013e3182368417.
Primary tumors of the lacrimal sac are extremely rare and predominantly epithelial in origin. We report a unique case of fibromyxoma of the lacrimal sac in an 86-year-old Caucasian woman who presented with 3 months of lower eyelid edema and 1 week of purulent discharge, epiphora, and acute pain. Examination revealed right lower eyelid erythema/edema and a tender, firm, palpable mass of the right lacrimal sac, which self-expressed a yellow, purulent discharge. On surgical exploration, a firm, rubbery, yellow mass was encountered and excised. Histopathologic analysis identified a nonencapsulated mass composed of loose interlacing fascicles and bundles of spindle-shaped cells with prominent myxoid changes; immunostaining was strongly positive for vimentin, weakly for smooth muscle actin, and negative for S-100 and muscle-specific actin. These findings were consistent with the diagnosis of a fibromyxoma of the lacrimal drainage system. After excision, the patient did well, with resolution of dacryocystitis.
泪囊原发性肿瘤极为罕见，主要来源于上皮组织。我们报告了 1 例 86 岁高加索女性的泪囊纤维黏液瘤，其主要表现为 3 个月的下眼睑水肿和 1 周的脓性分泌物、流泪和急性疼痛。检查发现右眼下眼睑红肿/水肿，右侧泪囊触诊有压痛、质地坚硬、可触及肿块，可自行排出黄色脓性分泌物。在手术探查时，遇到一个坚硬、有弹性、黄色的肿块，并进行了切除。组织病理学分析显示，肿块无包膜，由松散交织的束状和束状梭形细胞组成，伴有明显黏液样改变；免疫组化染色结果显示波形蛋白强阳性，平滑肌肌动蛋白弱阳性，S-100 和肌特异性肌动蛋白阴性。这些发现与泪液排出系统纤维黏液瘤的诊断一致。切除后，患者恢复良好，泪囊炎得到治愈。
