Sun Yongli, Zhao Benqi, Si Shancheng
Department of Ophthalmology, Lunan Eye Hospital, Linyi.
Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University.
J Craniofac Surg. 2025 Sep 1;36(6):e792-e793. doi: 10.1097/SCS.0000000000011444. Epub 2025 Apr 30.
A 61-year-old female presented with a 2-month history of a mass in the right lacrimal sac area after a 10-year persistent epiphora accompanied by occasional ipsilateral discharge. External examination revealed a subcutaneous mass of tough quality, clear boundaries, and poor mobility. Computed tomography showed a low-density oval mass. Axial fat-suppressed T1-weighted magnetic resonance imaging (MRI) showed a slight enhancement around the mass. The special feature of this case was that the slightly high-density oval image on CT, combined with incomplete blockage on dacryography, indicated the tendency of a soft tissue tumor outside the lacrimal sac, whereas the significantly enhanced boundary on MRI was more inclined to a cystic mass. Finally, the mass was excised diagnostically, external dacryocystorhinostomy combined with polyurethane stenting was performed, and histopathology suggested lacrimal sac mucocele. Here, the authors report a rare case of atypical adult-onset lacrimal sac mucocele and emphasize the importance of multimodal imaging evaluation for surgical guidance.
一名61岁女性，在持续10年溢泪并偶尔伴有同侧分泌物后，右侧泪囊区出现肿物2个月。外部检查发现皮下有一质地坚韧、边界清晰、活动度差的肿物。计算机断层扫描显示为低密度椭圆形肿物。轴位脂肪抑制T1加权磁共振成像（MRI）显示肿物周围有轻微强化。该病例的特殊之处在于，CT上的略高密度椭圆形影像，结合泪道造影的不完全阻塞，提示泪囊外软组织肿瘤的倾向，而MRI上明显强化的边界更倾向于囊性肿物。最后，对肿物进行诊断性切除，并行外路泪囊鼻腔吻合术联合聚氨酯支架置入术，组织病理学提示为泪囊黏液囊肿。在此，作者报告一例罕见的非典型成人泪囊黏液囊肿病例，并强调多模态影像评估对手术指导的重要性。
