Pyogenic Granuloma of the Lacrimal Sac: A Case Report
Lotfi Chaabani
*
Ophthalmology Department, Regional Hospital of Kasserine, Tunisia and Faculty of Medicine of Sousse, University of Sousse, Tunisia.
Yosra Doulemi
Ophthalmology Department, Regional Hospital of Kasserine, Tunisia.
Ksouri Saifedine
Ophthalmology Department, Regional Hospital of Kasserine, Tunisia and Faculty of Medicine of Sousse, University of Sousse, Tunisia.
*Author to whom correspondence should be addressed.
Abstract
Aims: This study reports a rare case of pyogenic granuloma of the lacrimal sac as a cause of chronic dacryocystitis, and to summarize its clinical features, management, and outcomes.
Presentation of Case: A 56-year-old man presented with chronic left dacryocystitis unresponsive to systemic antibiotics. Examination showed a reddish swelling over the lacrimal sac without reflux. External dacryocystorhinostomy revealed a 15 × 6 × 4 mm dark red mass, which was excised. Histopathology confirmed a pyogenic granuloma. Silicone intubation was performed. Recovery was uneventful, with no recurrence after two years.
Discussion: Pyogenic granuloma of the lacrimal sac is extremely rare (≈0.3% of lacrimal sac tumors), typically associated with trauma, foreign bodies, or arising spontaneously. It can mimic dacryocystitis and is often diagnosed intraoperatively. Histology shows benign vascular proliferation.
Conclusion: Pyogenic granuloma should be considered in chronic dacryocystitis with atypical features. Routine histopathological examination of lacrimal sac tissue may aid diagnosis, and its presence does not impair dacryocystorhinostomy outcomes.
Keywords: Pyogenic granuloma, lacrimal sac, dacryocystitis, dacryocystorhinostomy, benign tumor