A lacrimal sac mass with bloody discharge

We report a 38-year-old man who presented with a 7-year history of a mass in the right medial canthal region. He had several episodes of dacryocystitis, epiphora and bloody discharge. A cystic lesion was defined on MRI. Lacrimal sac excision was performed and a dark red mass was extirpated. External dacryocystorhinostomy and bicanalicular silicone tube intubation was performed. The polypoid lesion was diagnosed as an inflammatory polyp. Benign and malignant tumors of the lacrimal sac may have similar clinical findings on presentation. Preoperative ancillary testing may help us to have an idea of the nature of the lesion but histopathological examination is still the gold standard. Ophthalmologists should remember this similarity and be careful especially while performing endoscopic or laser-assisted dacryocystorhinostomy.