Nasolacrimal sac hematoma masquerading as an orbital mass.
A distended or infiltrated nasolacrimal sac can present as a mass in the medial orbit. We present a case of aspergillus sinusitis complicated by intractable epistaxis after debridement of the nasal septum, which caused pain and rapid distension of the nasolacrimal sac. The clinical and radiographic appearance of the distended nasolacrimal sac mimicked the appearance of an orbital mass and orbital extension of aspergillosis. After embolization of the maxillary artery to control the epistaxis, the nasolacrimal sac hematoma spontaneously resolved, and the patient proceeded with his medical treatment without the need for orbital surgery.
Yen
Michael T
MT
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030, USA. myen@bcm.tmc.edu
Hipps
W Michael
WM
D000293:Adolescent; D001228:Aspergillosis / Q000150:complications / Q000382:microbiology / Q000601:surgery; D003646:Debridement; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D004844:Epistaxis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005005:Ethmoid Sinus / Q000382:microbiology / Q000473:pathology; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008438:Maxillary Artery; D009301:Nasolacrimal Duct / Q000473:pathology*; D009918:Orbital Neoplasms / Q000175:diagnosis; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000382:microbiology / Q000601:surgery; D014057:Tomography, X-Ray Computed