Pyogenic Granuloma of the Lacrimal Sac: A Case Report

Abstract

Aims: This study reports a rare case of pyogenic granuloma of the lacrimal sac as a cause of chronic dacryocystitis, and to summarize its clinical features, management, and outcomes. Presentation of Case: A 56-year-old man presented with chronic left dacryocystitis unresponsive to systemic antibiotics. Examination showed a reddish swelling over the lacrimal sac without reflux. External dacryocystorhinostomy revealed a 15 × 6 × 4 mm dark red mass, which was excised. Histopathology confirmed a pyogenic granuloma. Silicone intubation was performed. Recovery was uneventful, with no recurrence after two years. Discussion: Pyogenic granuloma of the lacrimal sac is extremely rare (≈0.3% of lacrimal sac tumors), typically associated with trauma, foreign bodies, or arising spontaneously. It can mimic dacryocystitis and is often diagnosed intraoperatively. Histology shows benign vascular proliferation. Conclusion: Pyogenic granuloma should be considered in chronic dacryocystitis with atypical features. Routine histopathological examination of lacrimal sac tissue may aid diagnosis, and its presence does not impair dacryocystorhinostomy outcomes.