Unilateral congenital dacryocele

We report a case of a healthy, full term, 3 months old boy, who was referred for evaluation a bluish-gray cystic firm mass, measuring approximately 1-cm just below the medial canthal tendon of the right eye, present since birth. The diagnosis of unilateral congenital dacryocele was confirmed by CT-scan. In our case the dacryocele resolved after medical treatment which included: massage with warm compresses, antibiotics drops. We did not have recurrence over 10 months of follow-up. Previous studies have reported that congenital dacryocele, also known as nasolacrimal mucocele, is a rare form of congenital distension of the naso-lacrimal sac with both proximal and distal obstruction usually unilateral (approximately 25% are bilateral), and that is typically present at birth or in the first three months of life. Dacryoceles occur in 0.08% to 0.1% of newborns with congenital nasolacrimal duct obstruction as found by several authors, and patients may also have respiratory distress secondary to the intranasal cyst. The differential diagnosis reported in literature includes: includes encephalocele, capillary hemangioma, glioma and dermoid cyst. According to several studies the nasolacrimal mucocele can resolve spontaneously in majority of cases with medical treatment which includes antibiotics, warm compresses, and sac massage. However, surgical treatment may be necessary when self-resolution fails, to avoid infectious complication such as of dacryocystitis and preseptal cellulitis.