When a patient is presented with a subconjunctival cyst, it is not only hard to reveal its true nature clinically but also easy to rupture during excision. We experienced cases with cysts of the accessory lacrimal gland in two patients with subconjunctival cysts. They had lid swelling at initial presentation and underwent surgical excision of subconjunctival cysts located in superior portion of the upper tarsal plate. The lining of these cysts composed of ductal epithelia. Biochemical analyses for serum and cystic fluid were performed in one case, in which was found high Ig A titer in the cystic fluid. These cysts seemed to originate from the duct of Wolfring's accessory lacrimal gland, considering their anatomic locations and pathologic findings. Complete removal of the cyst is important, because recurrences have been reported in cases of incomplete removal or simple aspiration.
Adult ; Conjunctival Diseases/pathology/surgery ; Cysts/*pathology/surgery ; Female ; Humans ; Lacrimal Apparatus Diseases/*pathology/surgery ; Orbit/radiography ; Tomography, X-Ray Computed

Dermoid tumors in the medial canthal area are rare, but when present they commonly adhere to the lacrimal canaliculi. Three patients presented with a mass in the medial canthal area. The authors performed excisional biopsies, and the masses were diagnosed as dermoid tumors. In two patients, canalicular lacerations were found after mass excision, which suggested that the masses had been firmly adherent to the lacrimal canaliculi. The lacerated canaliculi were repaired after bicanalicular silicone intubation. In the remaining patient, lacrimal silicone intubation was performed at the beginning of surgery, and the mass was successfully dissected from the canaliculi, leaving them intact. Excision of dermoid tumors in the medial canthal area requires careful dissection to avoid canalicular laceration. Bicanalicular silicone intubation at the beginning of surgery is helpful for the identification of the canaliculi and for the prevention of canalicular laceration during dermoid tumor excision.
Adolescent ; Adult ; Dermoid Cyst/pathology/*surgery ; Female ; Humans ; Intubation ; Lacrimal Apparatus Diseases/pathology/*surgery ; Male ; Middle Aged ; Orbital Neoplasms/pathology/*surgery ; Postoperative Care ; Preoperative Care ; Silicones

Hemangiopericytomas are soft tissue tumors composed of pericapillary pericytes. These tumors are rare in the lacrimal sac. To the author's knowledge, only four previous cases of these tumors occurring in the lacrimal sac have been reported. A primary hemangiopericytoma of the lacrimal sac in a 34-year-old female is reported. Total excision with the surrounding tissue appears to be the treatment of choice for this tumor.
Adult ; Eye Neoplasms/*pathology/radiography/surgery ; Female ; Hemangiopericytoma/*pathology/radiography/surgery ; Humans ; Lacrimal Apparatus Diseases/*pathology/radiography/surgery ; Tomography, X-Ray Computed

No abstract available.
Aged ; Biopsy ; Carcinoma, Squamous Cell/diagnosis/*etiology ; Dacryocystorhinostomy/*adverse effects ; Eye Neoplasms/diagnosis/*etiology ; Female ; Humans ; Lacrimal Apparatus/pathology/*surgery ; Lacrimal Apparatus Diseases/diagnosis/*etiology ; *Postoperative Complications ; Tomography, X-Ray Computed

BACKGROUNDBenign lymphoepithelial lesion (BLEL) is characterized by symmetric bilateral swelling of the lacrimal and salivary glands and considered a subtype of immunoglobulin G4 (IgG4)-related sclerosing disease, the etiology and pathogenesis of which has not been determined. The purpose of the present study was to analyze the clinical features of BLEL in the lacrimal gland and the relationship between the serum level of IgG4 and BLEL.

METHODSTwenty consecutive patients with BLEL diagnosed in Department of Ophthalmology at Beijing Tongren Hospital, Capital Medical University between January 2012 and December 2013 were observed. The clinical features, imaging findings, laboratory tests, treatments and follow-up status of these 20 consecutive patients were analyzed.

RESULTSIn all 20 patients, the ratio of male to female was 1:4, the ages ranged from 28 to 57 years, the ratio of unilateral to bilateral eyes involvement was 1:4, and painless uncongested symmetrical swelling of the upper eyelid was the main clinical manifestation. Orbital magnetic resonance imaging (MRI) showed that all patients involved lacrimal gland, which were obviously enlarged with equal signals in T1W images and T2W images and obvious enhancement on contrast MRI. Extraocular muscles were involved in 5 patients, salivary gland in 8 patients, and frontal nerve in 3 patients. Serum IgG4 concentration was elevated in 18 patients. The treatment strategy mainly included surgery and steroid administration. Three patients were lost to follow-up, 17 patients reached complete response, and no recurrence was observed.

CONCLUSIONSEyelid swelling is the typical symptom of BLEL. Most of the patients involved bilateral lacrimal glands. High serum IgG4 level and abundant IgG4-positive plasma cell infiltration are the important features, which can be found in most of BLEL patients. Surgery combined with glucocorticoids is an efficient treatment strategy.

Adult ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Immunoglobulin G ; blood ; Lacrimal Apparatus ; pathology ; Lymphatic Diseases ; blood ; diagnosis ; drug therapy ; surgery ; Male ; Middle Aged