Case contributed by Ammar Haouimi
Diagnosis almost certain


Painless swelling of the left medial canthus.

Patient Data

Age: 75 years
Gender: Male

Small well-defined thin-walled cystic lesion of the left medial canthus with tapered upper margin. The content is of low signal on T1, high signal on T2 and T2 fat sat with a thin rim of peripheral enhancement on the postcontrast sequences.

Small vessel ischemic change is noted.

Case Discussion

The MRI features are most consistent with dacryocystocele.

Dacryocystoceles are due to an obstruction of both, proximal and distal ends of the nasolacrimal duct. They can cause:

  • nasal obstruction

  • become infected (dacryocystitis)

  • spontaneously rupture so that their contents drain into the nose

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