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Stein M, Hämmerle M, Viestenz A, Wickenhauser C, Glien A, Struck HG, Heichel J. [Pleomorphic adenoma of ectopic lacrimal gland tissue - management of a large extraconal retroaquaetorial tumor via anterior transcutaneous orbitotomy]. Laryngorhinootologie 2024. [PMID: 39074804 DOI: 10.1055/a-2341-1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Affiliation(s)
- Marlene Stein
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Halle, Deutschland
| | - Monika Hämmerle
- Institut für Pathologie, Martin-Luther-Universitat Halle-Wittenberg, Halle, Deutschland
| | - Arne Viestenz
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Halle, Deutschland
| | - Claudia Wickenhauser
- Institut für Pathologie, Martin-Luther-Universitat Halle-Wittenberg, Halle, Deutschland
| | - Alexander Glien
- Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Halle (Saale), Halle, Deutschland
| | - Hans-Gert Struck
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Halle, Deutschland
| | - Jens Heichel
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Halle, Deutschland
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Pupić-Bakrač A, Knežević J, Pupić-Bakrač J, Škegro I, Pavan J, Jukić A, Rašić M, Jukić T. Aesthetic and Functional Outcomes of Upper Blepharoplasty Combined with Dacryoadenopexy in Lacrimal Gland Prolapse. Aesthetic Plast Surg 2024; 48:2246-2253. [PMID: 38565726 DOI: 10.1007/s00266-024-03972-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Lacrimal gland prolapse (LGP) is a term used to describe a benign, anterior displacement of the lacrimal gland. If this condition is not properly addressed during upper blepharoplasty, the aesthetic and functional results are less than optimal. This study aimed to report the surgical outcomes of upper blepharoplasty combined with dacryoadenopexy in patients with LGP. METHODS We reported an unusual case of severe LGP in a young patient. In addition, we performed a systematic review of the English literature on surgical cases of LGP published between 1973 and 2023. Eligible articles were analyzed for individual patient data (IPD) and aggregate patient data (APD). The primary predictor variable was the surgical technique used for lacrimal gland repositioning/suspension. The primary outcome variable was relapse rate. RESULTS The bibliographic search retrieved 488 surgical cases of LGP: 12 in IPD, and 476 in APD datasets. The relapse rates in the IPD and APD cohorts were 8.3% (1/12) and 1.2% (6/476), respectively. Within the APD dataset, no significant difference in the relapse rates between dacryoadenopexy via suture suspension and Whitnall's ligament suspension (5/409 and 1/20, respectively; P > 0.05) was observed. Light cauterization of the lacrimal gland capsule and surrounding soft tissues was performed in mild LGP cases (< 4 mm prolapse), with a relapse rate of 0% (0/47). CONCLUSION Upper blepharoplasty combined with dacryoadenopexy proved to be a safe surgical procedure with very satisfactory aesthetic outcome and minimal relapse rate. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Ana Pupić-Bakrač
- Department of Ophthalmology, Dubrava University Hospital, Avenija Gojka Šuška 6, 10000, Zagreb, Croatia.
| | - Josip Knežević
- Department of Ophthalmology, University Hospital Centre Zagreb, Kišpatićeva ul. 12, 10000, Zagreb, Croatia
| | - Jure Pupić-Bakrač
- Department of Otorhinolaryngology and Maxillofacial Surgery, General Hospital Zadar, Bože Peričića 5, 23000, Zadar, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, University Hospital Centre Zagreb, Kišpatićeva ul. 12, 10000, Zagreb, Croatia
| | - Josip Pavan
- Department of Ophthalmology, Dubrava University Hospital, Avenija Gojka Šuška 6, 10000, Zagreb, Croatia
| | - Anđela Jukić
- Department of Ophthalmology, Dubrava University Hospital, Avenija Gojka Šuška 6, 10000, Zagreb, Croatia
| | - Mario Rašić
- Department of Otorhinolaryngology and Maxillofacial Surgery, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre, Ilica 197, 10000, Zagreb, Croatia
| | - Tomislav Jukić
- Department of Ophthalmology, University Hospital Centre Zagreb, Kišpatićeva ul. 12, 10000, Zagreb, Croatia
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Dharamdasani SS, Roy SS, Razdan T, Dhawan S. Epibulbar choristoma with pinguecula, a rare entity and a hitherto unreported coexistence. Oman J Ophthalmol 2024; 17:140-142. [PMID: 38524339 PMCID: PMC10957039 DOI: 10.4103/ojo.ojo_200_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/14/2023] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Affiliation(s)
| | - Snigdha S. Roy
- Department of Histopathology, Sir Gangaram Hospital, New Delhi, India
| | - Tinku Razdan
- Department of Ophthalmology, Sir Gangaram Hospital, New Delhi, India
| | - Shashi Dhawan
- Department of Histopathology, Sir Gangaram Hospital, New Delhi, India
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Stein M, Hämmerle M, Viestenz A, Wickenhauser C, Glien A, Struck HG, Heichel J. [Pleomorphic Adenoma of Ectopic Lacrimal Gland Tissue - Management of a Large Extraconal Retroaquaetorial Tumor via Anterior Transcutaneous Orbitotomy]. Klin Monbl Augenheilkd 2024; 241:10-14. [PMID: 37857327 DOI: 10.1055/a-2166-8334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Marlene Stein
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland
| | - Monika Hämmerle
- Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Arne Viestenz
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland
| | - Claudia Wickenhauser
- Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Alexander Glien
- Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohren-Heilkunde, Kopf- und Halschirurgie Universitätsklinikum Halle (Saale), Deutschland
| | - Hans-Gert Struck
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland
| | - Jens Heichel
- Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland
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5
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Herwig-Carl MC, Clemens A, Holz FG, Loeffler KU. [Ectopic conjunctival lacrimal gland]. DIE OPHTHALMOLOGIE 2023; 120:1201. [PMID: 37874362 DOI: 10.1007/s00347-023-01946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Martina C Herwig-Carl
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Venusberg Campus 1, Gebäude 04/05, 53127, Bonn, Deutschland.
- Sektion Ophthalmopathologie, Klinik für Augenheilkunde, Universitätsklinikum Bonn, Bonn, Deutschland.
| | - Amelie Clemens
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Venusberg Campus 1, Gebäude 04/05, 53127, Bonn, Deutschland
| | - Frank G Holz
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Venusberg Campus 1, Gebäude 04/05, 53127, Bonn, Deutschland
| | - Karin U Loeffler
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Venusberg Campus 1, Gebäude 04/05, 53127, Bonn, Deutschland
- Sektion Ophthalmopathologie, Klinik für Augenheilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
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Henares Chavarino ÁA, Estiragués Cerdá M, Ros Magallón A, Vicente Ruiz M, Arroyo Pérez Í, Bazán Álvarez A. Correction of Lacrimal Gland Ptosis in Blepharoplasty: A Systematic Review. Ophthalmic Plast Reconstr Surg 2023; 39:427-432. [PMID: 37010058 DOI: 10.1097/iop.0000000000002388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
PURPOSE Lacrimal gland ptosis has a prevalence of 10% to 15% in Caucasian patients, reaching up to 60% in older age. Its involuntary resection during blepharoplasty carries the potential risk of compromising corneal lubrication. The purpose of this systematic review is to check whether there is a consensus in the literature regarding the surgical procedure of choice and which outcomes and complications have been observed. METHODS A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was carried out in the Medline, Scopus, and Cochrane databases in March 2022. RESULTS A total of 16 studies involving 483 patients with lacrimal gland ptosis have been included. In 90.06% of patients, resuspension or direct refixation of the gland to the lacrimal fossa with suture to the orbital periosteum was performed. Follow up has been inconsistent, with an average of 18 months. Regarding complications, 5 recurrences and only 2 patients with persistent dry eye were observed. CONCLUSIONS In general, the evidence is sparse. Nevertheless, repair of lacrimal gland ptosis is a relatively simple, reproducible, and safe surgical technique, with a low likelihood of recurrence, severe, or persistent complications. A classification is proposed for both the grading of ptosis and its treatment.
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Choi JY, Jang YK, Han JC. Complication of Ectopic Lacrimal Gland Tumor on Long-term Follow-up: A Case Report. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:348-349. [PMID: 37336510 PMCID: PMC10427904 DOI: 10.3341/kjo.2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/21/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- Ji Youn Choi
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Kyung Jang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Chul Han
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Macri C, Juniat V, Davis G, Selva D. Intraorbital and intracranial extension of adenoid cystic carcinoma without clinical or radiological lacrimal gland involvement. Orbit 2022; 41:797-801. [PMID: 34107855 DOI: 10.1080/01676830.2021.1939731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare epithelial neoplasm of the head and neck, most commonly found in the salivary glands. Orbital AdCC is an uncommon clinical entity arising from the lacrimal glands, however primary orbital AdCC has been previously described in a small number of case reports. The exact origin of the neoplasm with uninvolved lacrimal gland in the orbit is unknown, however it may arise from ectopic lacrimal or salivary gland tissue, or extension from nearby epithelial structures. We describe the clinical characteristics, investigations and management of a 55-year-old man presenting with vertical diplopia, found to have left posterior orbital AdCC invading the skull base with intracranial extension involving the inferotemporal fossa, pterygopalatine fossa, left carotid artery, cavernous sinus and temporal lobe dura, without clinical or radiological lacrimal gland involvement or systemic metastases.
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Affiliation(s)
- Carmelo Macri
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Garry Davis
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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O'Rourke MA, Cannon PS, Shaw JF, Irion LC, McKelvie PA, McNab AA. Cutaneous pleomorphic adenoma of the periocular region - a case series. Orbit 2022; 41:361-364. [PMID: 33292052 DOI: 10.1080/01676830.2020.1856884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
Mixed tumour of the skin is a rare entity also known as chondroid syringoma and pleomorphic adenoma. These usually present as slow-growing skin nodules with a smooth surface, clear boundaries, and no ulceration. Case series exist describing pleomorphic adenomas in the periocular region including the lids and orbit, separate to the more familiar lacrimal gland pleomorphic adenoma. These may arise from accessory or ectopic lacrimal gland tissue but in the eyelids are more likely to arise from sweat glands in the skin. Histopathological analysis of these lesions is important to identify complete excision, minimising recurrences and in identifying rare but potential malignant transformation. We describe the clinical features and outcomes in three cases of pleomorphic adenoma with two at the medial canthus (including one recurrence) and one in the brow region.
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Affiliation(s)
- Micheal A O'Rourke
- Orbital, Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Oculoplastic, Orbit and Lacrimal Surgery, Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Paul S Cannon
- Department of Oculoplastic, Orbit and Lacrimal Surgery, Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Joseph F Shaw
- Department of Histopathology, Manchester University NHS Foundation Trust, National Specialist Ophthalmic Pathology Service, Manchester, UK
| | - Luciane C Irion
- Department of Histopathology, Manchester University NHS Foundation Trust, National Specialist Ophthalmic Pathology Service, Manchester, UK
| | - Penelope A McKelvie
- Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Australia
| | - Alan A McNab
- Orbital, Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
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Azhany Y, Kwok IUK, Sakinah Z, Elmina M. Ectopic lacrimal gland causing intermittent proptosis. Taiwan J Ophthalmol 2022; 12:106-108. [PMID: 35399977 PMCID: PMC8988986 DOI: 10.4103/tjo.tjo_49_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/14/2020] [Indexed: 11/23/2022] Open
Abstract
Unilateral proptosis secondary to ectopic lacrimal gland tissue is rare. The most common site of ectopic lacrimal gland tissue is at the bulbar conjunctiva and limbal area. Although uncommon, intraorbital ectopic lacrimal gland tissue may mimic other ominous symptoms of intraorbital neoplasm in childhood. We present a rare case of intraconal ectopic lacrimal gland tissue in a 14-year-old girl with intermittent proptosis since childhood associated with subconjunctival hemorrhage and excruciating pain. She underwent lateral orbitotomy with orbital mass excision that resulted in good outcomes and no recurrence was seen at 6 months after the surgery.
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Duarte AF, Alpuim Costa D, Caçador N, Boavida AM, Afonso AM, Vilares M, Devoto M. Adenoid cystic carcinoma of the palpebral lobe of the lacrimal gland - case report and literature review. Orbit 2021; 41:605-610. [PMID: 33749533 DOI: 10.1080/01676830.2021.1901293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Epithelial tumors of the lacrimal gland are rare and usually develop in the orbital lobe. We report the exceedingly rare occurrence of a primary adenoid cystic carcinoma in the palpebral lobe of the lacrimal gland. A 26-year-old female was referred for evaluation of a gradually enlarging mass in the lateral upper eyelid, previously diagnosed as a chalazion. Computed tomography revealed a heterogeneous round lesion anterior to the orbital rim. Excisional biopsy was compatible with an adenoid cystic carcinoma. After excluding distant metastasis, and as the patient refused adjuvant radiotherapy, a second surgical procedure, with wide local excision, was indicated. Follow-up showed no recurrence. This case highlights the importance of performing a thorough clinical examination when diagnosing any lateral upper eyelid mass. A high index of suspicion for malignant tumors of the lacrimal gland should always be maintained, and a complete excision with histological analysis should be preferred whenever possible.
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Affiliation(s)
- Ana Filipa Duarte
- Department of Ophthalmology, Hospital CUF Descobertas, Lisbon, Portugal
| | | | - Nuno Caçador
- Department of Radiology, Hospital CUF Descobertas, Lisbon, Portugal
| | | | - Ana M Afonso
- Department of Pathology, Hospital CUF Descobertas, Lisbon, Portugal
| | - Miguel Vilares
- Department of Head and Neck Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E. (IPOL-FG), Lisbon, Portugal
| | - Martin Devoto
- Department of Ophthalmology, Clinica Consultores Oftalmológicos, Buenos Aires, Argentina
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Lv M, Dong ZJ, Tong YX, Li T, Hei Y, Yang XJ, Dong WL. Retrospective Analysis of Clinicopathological Characteristics of Lacrimal Gland Pleomorphic Adenoma and Mechanism of Tumorigenesis by the Imbalance Between Apoptosis and Proliferation. Med Sci Monit 2021; 27:e929152. [PMID: 33737504 PMCID: PMC7986817 DOI: 10.12659/msm.929152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Lacrimal gland pleomorphic adenoma (LGPA) is the most common clinically benign epithelial tumor of the lacrimal gland and is predominantly comprised of epithelial cells and interstitial components. At present, the exact pathogenesis of LGPA remains unclear. Previous research has indicated that the occurrence of LGPA may be related to excessive cell proliferation. MATERIAL AND METHODS This study observed the clinicopathological characteristics of LGPA and investigated the tumorigenesis mechanism of cell over-proliferation caused by the imbalance between apoptosis and proliferation. A total of 27 cases were collected from the Department of Ophthalmology of the Affiliated Hospital of Chengde Medical University and the Third Medical Center of Chinese PLA General Hospital from April 2017 to November 2019. Hematoxylin-eosin (HE) staining and immunohistochemical staining were used to observe the pathological characteristics and analyze the expression of bcl-2 and bax in the lacrimal gland. RESULTS Compared with normal lacrimal gland tissues, LGPA tumor tissues had obvious changes in pathological morphology. The expression of bcl-2 in LGPA lesion tissues was dramatically higher (P<0.001), the expression of bax was not significantly different between groups (P=0.25), but the ratio of bcl-2/bax was significantly higher in tumor tissues (P=0.01). CONCLUSIONS We found that the lacrimal gland tumor tissues had obvious excessive proliferation in pathomorphology, which revealed the necessity of complete surgical removal of the capsule from the perspective of pathological morphology and provided a theoretical basis for the hypothesis that the imbalance between apoptosis and proliferation could lead to cell hyperproliferation.
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Affiliation(s)
- Meng Lv
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China (mainland)
| | - Zhi-Jun Dong
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China (mainland)
| | - Yue-Xin Tong
- Department of Minimally Invasive Spine Surgery, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China (mainland)
| | - Tian Li
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China (mainland)
| | - Yan Hei
- The Institute of Orbital Disease, The Third Medical Center of Chinese PLA General Hospital, Beijing, China (mainland)
| | - Xin-Ji Yang
- The Institute of Orbital Disease, The Third Medical Center of Chinese PLA General Hospital, Beijing, China (mainland)
| | - Wei-Li Dong
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China (mainland)
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Steinmetz A, von Bomhard W, Mülling C. Dacryops with extensive lacrimal and maxillary bone defects in four dogs. Vet Ophthalmol 2021; 24:195-202. [PMID: 33444470 DOI: 10.1111/vop.12860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/08/2020] [Accepted: 12/28/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe and discuss ventromedial orbital lacrimal gland or duct cysts (dacryops) in dogs with extensive bone defects based on their symptoms, results of diagnostic imaging and histopathological examination, and therapy and discuss their potential origin based on the morphology. ANIMALS STUDIED Four dogs of different breeds, age, and sex were presented with a unilateral round, slow growing, indolent, and non-tender process ventromedial to the nasal canthus of the eye. PROCEDURES Transverse computed tomography showed a low-density, non-contrast-enhancing cystic process ventromedial to the globe with extensive defects in the lacrimal and maxillary bones in all cases. The cystic character of the structure was confirmed by the aspiration of the brownish fluid without cellular and microbiological contents. For treatment, the cystic fluid was aspirated, and the sclerosing agent polidocanol was injected in three cases. Cystorhinostomy (nasal marsupialisation) was performed in one case as the first choice and in another case following failure of sclerotherapy. Histopathological examination of the cyst walls was performed in two cases and confirmed the diagnosis of dacryops. RESULTS Follow-up between 2 and 18 months showed no recurrence and very good to excellent cosmetic results. CONCLUSIONS Aberrant lacrimal gland or duct tissue with secondary development of dacryops should be included in the differential diagnoses of ventromedial orbital cysts. Large cysts near the lacrimal drainage system with extensive bone defects in dogs should be treated by nasal marsupialization. Treatments such as evacuation of the cyst and inducing sclerosis (sclerotherapy) should be reserved for exceptional cases.
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Affiliation(s)
| | | | - Christoph Mülling
- Institute of Veterinary Anatomy, Leipzig University, Leipzig, Germany
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