Rhabdomyosarcoma masquerading as acute dacryocystitis

An 11-year-old boy presented with right medial canthal swelling. He was initially diagnosed with dacryocystitis and treated with oral antibiotics, followed by incision and drainage of a presumed lacrimal sac abscess. Rapid recurrence of the swelling led to further clinical evaluation, including a maxillofacial CT, which revealed an extensive nasal and orbital mass that was consistent with embryonal rhabdomyosarcoma on histopathologic analysis. This represents an unusual case of rhabdomyosarcoma manifesting as acute dacryocystitis. Rhabdomyosarcoma should be considered in the differential diagnosis for acquired nasolacrimal obstruction and dacryocystitis in the pediatric population.