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G. Scott, V. M. Elner, B. R. Frueh; Fibrous Dysplasia of the Lacrimal Sac Masquerading as a Tumor. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3584.
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To describe a case of a 75-year-old woman with fibrous dysplasia of the lacrimal sac, masquerading as a tumor.
Review of the clinical presentation, imaging, and histopathology.
A 75-year-old woman presented with complaints of epiphora and a slow growing mass in the right medial canthus, present for one year. The mass was firm to palpation and non-tender. There was minimal erythema of the overlying skin. CT scan with contrast showed a well-marginated, hyperdense, mildly nonhomogeneous, calcified-appearing mass measuring 9.1 x 9.9 x 8.2 mm in the expected location of the right lacrimal sac. Contrast enhancement of the mass was minimal and there was no erosion of osseous structures nearby. A right dacryocystorhinostomy was performed and a tan, hard, nearly spherical mass was removed from the lacrimal sac. The mass was not adherent to the lacrimal sac mucosa, which appeared normal. Histopathologic examination demonstrated disconnected trabeculae of bone with surrounding mesenchymal stroma, consistent with fibrous dysplasia.
To our knowledge, there are no reports of fibrous dysplasia of the lacrimal sac in the literature. It is not known exactly how fibrous dysplasia developed inside the lacrimal sac, but one may postulate it arose from primitive mesenchymal tissue. This entity should be included in the differential diagnosis of lacrimal sac masses.
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