Nasolacrimal duct mucocele

Case contributed by Dr Dalia Ibrahim

Presentation

20 day old baby presented with left medial canthus swelling. His physician suspected a epidermoid/dermoid cyst.

Patient Data

Age: 20 day
Gender: Female
MRI

A medial canthus cyst (eliciting high signal at T1WI and T2WI and fluid level at T2WI with no evidence of signal suppression at the fat saturation sequences denoting of its proteinaceous contents). This represents an enlarged lacrimal sac which appears in contiguity with enlarged nasolacrimal duct.

An enlarged osseous nasolacrimal canal secondary to an enlarged soft tissue nasolacrimal duct.

An intranasal cystic mass which represents the inferior extension of the mucocele.

Annotated image

 The following triad of imaging findings :

  • a medial canthus mass that represents an enlarged lacrimal sac (dacrocystocele) in contiguity with enlarged nasolacrimal duct
  • an enlarged osseous nasolacrimal canal secondary to an enlarged soft tissue nasolacrimal duct
  • an intranasal cystic mass which represents the inferior extension of the mucocele

Case Discussion

Nasolacrimal duct mucocele represents a cystic dilatation of the nasolacrimal apparatus secondary to proximal +/- distal obstruction of the nasolacrimal duct.

Tears and mucus accumulate in nasolacrimal duct with imperforate Hasner membrane (distal duct obstruction). The following triad of imaging findings.

  • a medial canthus mass that represents an enlarged lacrimal sac (dacrocystocele) in contiguity with enlarged nasolacrimal duct
  • an enlarged osseous nasolacrimal canal secondary to an enlarged soft tissue nasolacrimal duct
  • an intranasal cystic mass which represents the inferior extension of the mucocele
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Case information

rID: 44483
Case created: 23rd Apr 2016
Last edited: 24th Mar 2017
Inclusion in quiz mode: Included

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