A Case of Bilateral Dacryocystocele with Absence of the Lacrimal Puncta

A 33-year-old female suffered from bilateral mass in the medial area and epiphora for 20 years. The mass recurred after incomplete removal several times. Ocular examination showed that the puncta and papillae of the both lower and upper lids were completely missing. At operation, there was obstruction in the bony portion of the nasolacrimal duct. The mass was a distended lacrimal sac. The lacrimal sac and the mucosa of the nasolacrimal duct were compJetely excised in the right side. The excision of lacrimal sac and mucosa of the nasolacrimal duct and conjunctivo-rhinostomy using Jones tube were performed in the left side. Nine months after operation, the patient was happy with the results and there was no recurrence.

A Case of Adenoid Cystic Carcinoma of the Lacrimal Gland

A 49-year-old man had a 5-year history of left proptisis accompanied by headache, ocular pain, ocular motility and visual disturbance. Corrected visual acuity was 1.0 in the right and 0.2 in the left eye. There was 9mm of left proptosis by Hertel exophthalmometry. A hard, nontender mass was palpable in the superotemporal part of the orbit. Lateral and up gaze were impaired in the left eye. On the slit lamp examination of the left eye, there were moderate corneal edema and erosions resulting from lagophthalmos. Computed axial tomgraphy showed a large ill-defined massi with homogenous enhancement in the superior temporal part of the left orbit. The mass was removed by modified Kronlein operation as much as possible and diagnosed as the adenoid cystic carcinoma of the lacrimal gland by the light microscopic examination. The tumor cell already extended to contiguous bone, blood vessel. perineurium and adjacent muscles. One month after the operation, 5040 rad of radiation therapy was given. The mass was remarkably decreased in size after radiation. We are planning further radiation therapy now.