Dacryocystocele after successful external dacryocystorhinostomy: A variant of the lacrimal sump syndrome

A 25-year-old man presented with a mass on the right medial canthus after a successful dacryocystorhinostomy performed 3 years ago. On examination, there was a frm, nondepressible mass inferior to the medial canthal ligament and a linear vertical scar on the lateral wall of the nose. Syringing through the right lower punctum indicated his lacrimal system was patent. Computed tomography and magnetic resonance imaging disclosed a large cystic lesion in the lacrimal sac fossa. No bone erosion was detected. The mass was approached through a tear trough incision and completely resected. The lacrimal anastomosis that was highly placed remained patent after surgery. Histopathology of the specimen revealed a cystic lesion compatible with lacrimal origin (dacryocystocele).