Congenital dacryocystocele: comparative findings of dacryoendoscopy and histopathology in a patient.

A full-term baby girl showed a bluish mass at birth in the right medial canthal area. She later demonstrated dacryocystitis and cellulitis. Although probing was performed, it was unsuccessful, and the dacryocystitis and cellulitis worsened. Computed tomography showed a dilated lacrimal sac, an enlarged nasolacrimal canal and a nasal cyst. Topical and intravenous systemic antibiotics were then started, and the symptoms partially subsided. Surgery was performed under general anesthesia with endoscopic assistance, under which cystic distention was visualized beneath the inferior turbinate. A dacryoendoscope showed injection and hemorrhages on the inner wall of the cyst. Marsupialization of the cyst was performed. Histopathologic examination showed submucosal tissue including fibrous thickening with infiltration of mononuclear leukocytes. The patient remained symptom free 6 months thereafter. Dacryoendoscopy for a congenital dacryocystocele demonstrated injection with hemorrhages, and this inflammatory sign corresponded to the histopathologic findings.