Abstract
Objective
The study aims to describe the clinical and histopathologic features of different
types of dacryops and their clinical diagnostic challenges.
Methods
This is a retrospective cohort study of all surgically excised cases of dacryops in
2 tertiary eye hospitals in Riyadh, Saudi Arabia.
Results
The study included 58 dacryops specimens from 55 patients with an average age of 41.2
years (range, 4–78 years). The most common location was the upper lid (60.3%), whereas
the least expected location was the caruncle (6.9%). The most common site of dacryops
occurrence was in the accessory lacrimal gland (55.2%), the main lacrimal gland (32.8%),
and then ectopic dacryops (12%). All patients presented with lid swelling alone except
for 3 patients who experienced secondary mechanical ptosis. On physical examination,
conjunctival scarring existed in 4 patients (6.9%). Preoperative diagnosis of dacryops
was accurate in 44.8% of the cases. Dacryops of the main lacrimal gland was accurately
diagnosed clinically in all cases compared with other locations, which was statistically
significant (p < 0.001). The causes of inaccurate clinical diagnoses were hidrocystoma (26.9%),
inclusion cyst (11.5%), and dermoid cyst (7.7%), whereas the remaining cases were
diagnosed as cysts without a specific subtype (53.9%). Recurrence of the lesion was
observed in 2 cases (3.5%). No clinical or histopathologic factors were associated
with a risk of recurrence.
Conclusion
Dacryops can represent a diagnostic challenge to ophthalmologists. Familiarity with
clinical presentations and findings is required to diagnose dacryops outside the main
lacrimal gland.
Objectif
La présente étude visait à décrire les caractéristiques cliniques et histopathologiques
de différents types de dacryops ainsi que leurs défis diagnostiques sur le plan clinique.
Méthodes
Il s'agit d'une étude de cohorte rétrospective portant sur tous les cas de dacryops
ayant fait l'objet d'une excision chirurgicale dans 2 hôpitaux de soins oculaires
tertiaires à Riyad, en Arabie saoudite.
Résultats
L’étude regroupait 58 cas de dacryops provenant de 55 patients (âge moyen : 41,2 ans;
fourchette : 4–78 ans). La localisation la plus fréquente était la paupière supérieure
(60,3 %), tandis que la forme la plus inattendue était la caroncule (6,9 %). Les autres
sièges les plus fréquents du dacryops étaient les suivants : glande lacrymale accessoire
(55,2 %), glande lacrymale principale (32,8 %) et dacryops à l'extérieur de la glande
lacrymale (12 %). Tous les patients présentaient un œdème de la paupière seul, à l'exception
de 3 patients, qui présentaient une ptose mécanique secondaire. Lors de l'examen physique,
on a noté la présence d'une cicatrice conjonctivale chez 4 patients (6,9 %). Le diagnostic
préopératoire du dacryops était exact dans 44,8 % des cas. Comparativement aux autres
localisations, tous les cas de dacryops touchant la glande lacrymale principale ont
reçu un diagnostic clinique exact, ce qui était significatif sur le plan statistique
(p < 0,001). Voici la liste des diagnostics cliniques erronés : hidrocystome (26,9 %),
kyste d'inclusion (11,5 %) et kyste dermoïde (7,7 %), les autres cas ayant reçu un
diagnostic de kyste aspécifique (53,9 %). Il s'est produit une récurrence de la lésion
chez 2 patients (3,5 %). Aucun facteur clinique ni histopathologique n'a été associé
à un risque de récurrence.
Conclusion
Le dacryops peut constituer un défi sur le plan diagnostique, de sorte qu'il est important
que les ophtalmologistes se familiarisent avec les présentations et caractéristiques
cliniques des dacryops pour qu'ils puissent reconnaître les cas qui surgissent à l'extérieur
de la glande lacrymale principale.
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Article info
Publication history
Published online: July 26, 2021
Accepted:
June 23,
2021
Received:
April 28,
2021
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
