Department of Opthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-qiao Road, Chengdu, 610072, Sichuan Province, PR China.
Department of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
BMC Ophthalmol. 2021 Dec 29;21(1):458. doi: 10.1186/s12886-021-02223-8.
This study aims to explore a case of exophytic nasal papilloma with acute dacryocystitis as the first symptom.
A 72-year-old male patient complaining of "a 10-year history of tearing and purulent discharge from the right eye, with subsequent redness and pain in the inner canthus for three days" was initially diagnosed with acute dacryocystitis of the right eye. The patient was treated with anti-inflammatory therapy. However, the redness and swelling of the inner canthus continued to increase. An endoscopic dacryocystorhinostomy of the right eye was performed under general anesthesia. A large amount of purulent secretion was drained during the operation. As a result, the swelling of the inner canthus was significantly reduced. A routine intra-operative biopsy of the wall of the lacrimal sac revealed an exophytic nasal papilloma. A second biopsy, 1 week after the surgery, revealed the same result. The patient was advised to undergo a dacryocystectomy once the swelling had subsided. However, the patient was reluctant to undergo this surgery and remains under clinical observation.
It is rare for an exophytic nasal papilloma, which is a benign tumor in the lacrimal sac, which has the potential for recurrence and malignant transformation, to manifest with acute dacryocystitis as the first symptom. Therefore, this case report could provide a reference for the future clinical diagnosis of this disease.
本研究旨在探讨一例以急性泪囊炎为首发症状的外生性鼻乳头状瘤病例。
一名 72 岁男性患者因“右眼流泪伴脓性分泌物 10 年,随后内眼角红肿疼痛 3 天”就诊,最初被诊断为右眼急性泪囊炎。患者接受了抗炎治疗,但内眼角的红肿仍持续加重。在全身麻醉下进行了右眼鼻内窥镜下泪囊鼻腔吻合术。术中引流出大量脓性分泌物,内眼角肿胀明显减轻。泪囊壁的常规术中活检显示为外生性鼻乳头状瘤。术后 1 周的第二次活检结果相同。建议患者待肿胀消退后行泪囊切除术,但患者不愿手术,目前仍在临床观察中。
外生性鼻乳头状瘤是一种泪囊的良性肿瘤,具有复发和恶变的潜能,以急性泪囊炎为首发症状较为罕见。因此,本病例报告可为该病的临床诊断提供参考。