Juvenile xanthogranuloma of the lacrimal sac fossa

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Abstract

Masses involving the medial canthus and lacrimal sac fossa include dacryocystoceles and, less commonly, mucoceles, hemangiomas, diverticula, and lacrimal sac neoplasms. To our knowledge, juvenile xanthogranuloma presenting as a lacrimal sac fossa mass has not been previously reported.We examined a 2-year-old boy who had epiphora in the left eye since birth and a mass in the left lacrimal sac fossa for 6 weeks. During surgery, left lacrimal probing disclosed obstruction at the level of the common canaliculus and lacrimal sac. Exploration and excision of the mass were performed.Histopathologic evaluation disclosed a juvenile xanthogranuloma characterized by an inflammatory cell infiltrate with foamy histiocytes and scattered Touton-type multinucleated giant cells.Juvenile xanthogranuloma should be included in the differential diagnosis of a medial canthal and lacrimal sac fossa mass.

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