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Pigmented orbital mass due to remote pencil trauma
Brian J Lee1, Shivani Gupta, Andrew Flint
1Department of Ophthalmology, University of Michigan, Ann Arbor, MI 48105, USA.
Ophthalmic Plastic and Reconstructive Surgery
|August 2, 2011
Summary
A graphite-induced granuloma caused a medial canthal mass and epiphora in a patient with a history of intranasal pencil trauma. Surgical removal of the granuloma and dacryocystorhinostomy led to a full recovery.
Area of Science:
- Ophthalmology
- Pathology
Background:
- A medial canthal mass and epiphora can present with various etiologies.
- Intranasal trauma is a less common cause of lacrimal sac pathology.
Observation:
- A 45-year-old woman presented with a medial canthal mass and new-onset epiphora.
- Imaging revealed a darkly pigmented mass originating from the lacrimal sac wall.
Findings:
- Histopathological examination confirmed a graphite-induced granuloma.
- The granuloma resulted from intranasal pencil trauma sustained 40 years prior.
Implications:
- This case highlights a rare, long-term consequence of intranasal foreign bodies.
- Prompt diagnosis and surgical intervention, including dacryocystorhinostomy, can be curative for graphite-induced granulomas.
- Ophthalmologists should consider remote trauma in the differential diagnosis of lacrimal sac masses.
