Congenital nasolacrimal duct mucocele - a case report

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					The Turkish Journal of Pediatrics 2010; 52: 194-197                                                             Case



Congenital nasolacrimal duct mucocele – a case report
Andrzej Brodkiewicz1, Anna Zakowska1, Jarosław Peregud-Pogorzelski1, Maria Gizewska2,
Mirosław Burak3, Magdalena Pastuszak-Gabinowska1
1Division of Pediatrics, Hematology and Pediatric Oncology, and 2Division of Pediatrics, Endocrinology, Diabetology,

Metabolic Diseases and Cardiology, and 3Department of Diagnostic Imaging and Interventional Radiology, Pomeranian
Medical University, Szczecin, Poland



                            SUMMARY: Brodkiewicz A, Zakowska A, Peregud-Pogorzelski J, Gizewska M,
                            Burak M, Pastuszak-Gabinowska M. Congenital nasolacrimal duct mucocele
                            - a case report. Turk J Pediatr 2010; 52: 194-197.
                            Congenital nasolacrimal duct mucocele (CNDM) is a very rare condition in
                            newborns. Prolapse or expansion of the mucocele into the nose may lead to
                            respiratory distress and difficulty in feeding. The triad of cystic medial canthal
                            mass, dilatation of the nasolacrimal duct and a contiguous sub-mucosal nasal
                            mass on computed tomography (CT) is indicative in the diagnosis of CNDM.
                            The case of a five-week-old girl with infected CNDM is described. The authors
                            aim to emphasize the very rare incidence of CNDM in Polish newborns,
                            delayed diagnosis in the case described and the paramount importance of
                            CT of the head for the correct diagnosis and treatment.
                            Key words: tumor, nasolacrimal duct mucocele, child, computed tomography.




Congenital nasolacrimal duct mucocele                       respiratory distress secondary to nasal pathology
(CNDM) is a very rare condition in newborns.                includes a variety of congenital malformations
Prolapse or expansion of the mucocele into                  (e.g. choanal atresia, meningoencephalocele,
the nose may lead to respiratory distress                   hemangioma, dermoid cyst, Thornwald cyst,
and difficulty in feeding, as newborns are                  pyriform aperture stenosis), neoplastic tumors
preferential nose breathers1. A lacrimal sac                and hamartomas, trauma, and local infections2,4-
mucocele (LSM) occurs when the normal                       6 . Computed tomography (CT), magnetic

flow of tears through the nasolacrimal duct                 resonance imaging (MRI), ultrasonography
is obstructed, resulting in medial canthus                  (USG), and nasal endoscopy play key roles
mass. CNDM occurs when a LSM is directly                    in the diagnosis of CNDM and differential
contiguous with a cystic intranasal mass via                diagnosis of other lesions of this region
a dilated nasolacrimal duct2. A mucocele is                 (especially including neoplasms)3,5. Several
usually lined by ciliated columnar epithelium               treatment modalities have been proposed for
with goblet cells and secondarily filled with               the management of CNDM5,7,8. Spontaneous
mucus and epithelial debris. Should this closed             resolution may also occur.
system develop a secondary infection, it is
then called a mucopyocele1. Embryologically,                Case Report
the nasolacrimal passageway arises from a
                                                            The five-week-old girl was admitted to the
thickening of 
				
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