Atypical presentation of a dacryolith

To describe the clinical features and management of a patient with an extralacrimal dacryolith.

Case report.

A 43-year-old woman remarked at a routine eye examination that a small, firm mass located for several years on the right side of her nose had recently become slightly larger. The mass had remained firm and nontender during this enlargement. She explicitly denied having any past or current lacrimal outflow problems. Surgical excision disclosed a mass external to the lacrimal sac and duct, adherent to its lateral wall. The histopathologic features were consistent with a dacryolith surrounded by a chronic inflammatory reaction and no epithelial lining.

We presume that the dacryolith must have formed within the lacrimal sac and then migrated laterally into the surrounding soft tissue.