title: Acquired lacrimal sac fistula mimicking basal cell carcinoma.
abstract: BACKGROUND
  Lacrimal sac fistulae can arise after an episode of dacryocystitis, usually forming below the medial canthus. Preceding symptoms of a watery eye with mucous discharge and a history or signs of inflammation are typical.
  
  
  OBJECTIVE
  To highlight the features of lacrimal sac fistulae and encourage readers to consider this in the differential diagnosis of apparently ulcerative medial canthal skin lesions.
  
  
  METHODS
  We describe three patients with inferior-medial canthal ulcerative skin lesions, all referred to ophthalmic plastic surgeons either by dermatologists or plastic surgeons, presumed clinically to have basal cell carcinoma (BCC).
  
  
  RESULTS
  All three were in fact due to acquired lacrimal sac fistulae, and syringing of the nasolacrimal system confirmed the presence of a fistula.
  
  
  CONCLUSIONS
  These cases illustrate the importance of questioning patients about their previous ocular symptoms when dealing with less familiar periocular lesions.
authors: Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex RH19 3DZ, UK.
authors: A S
authors: AS
authors: Litwin
authors: H
authors: H
authors: Timlin
authors: S
authors: S
authors: Sagili
authors: M
authors: M
authors: Wright
authors: R
authors: R
authors: Malhotra
mesh_terms: D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005402:Fistula / Q000175:diagnosis*; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis*; D012965:Sodium Chloride
chemical_list: D012965:Sodium Chloride