title: Fibromyxoma masquerading as dacryocystitis.
abstract: Primary tumors of the lacrimal sac are extremely rare and predominantly epithelial in origin. We report a unique case of fibromyxoma of the lacrimal sac in an 86-year-old Caucasian woman who presented with 3 months of lower eyelid edema and 1 week of purulent discharge, epiphora, and acute pain. Examination revealed right lower eyelid erythema/edema and a tender, firm, palpable mass of the right lacrimal sac, which self-expressed a yellow, purulent discharge. On surgical exploration, a firm, rubbery, yellow mass was encountered and excised. Histopathologic analysis identified a nonencapsulated mass composed of loose interlacing fascicles and bundles of spindle-shaped cells with prominent myxoid changes; immunostaining was strongly positive for vimentin, weakly for smooth muscle actin, and negative for S-100 and muscle-specific actin. These findings were consistent with the diagnosis of a fibromyxoma of the lacrimal drainage system. After excision, the patient did well, with resolution of dacryocystitis.
authors.affiliation: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030 , USA.
authors.forename: Arindel S R
authors.initials: AS
authors.lastname: Maharaj
authors.forename: Seongmu
authors.initials: S
authors.lastname: Lee
authors.forename: Michael T
authors.initials: MT
authors.lastname: Yen
mesh_terms: D000369:Aged, 80 and over; D003607:Dacryocystitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis* / Q000601:surgery