Fungal dacryops: a rare presentation

A woman in her late 40s presented with a cystic lesion in the left lacrimal gland for 1 year and associated pain in the past 3 months. On examination, the patient had cystic lesion in the left lacrimal gland region without any signs of inflammation. An initial provisional diagnosis of simple dacryops of the left eye was made, and the lesion was observed. On review at 1 month, the patient complained of persistent swelling and dull pain in the left eye. Excisional biopsy of the lesion was planned. Intraoperatively, the cyst ruptured during surgery, and yellowish, granule-like concretions were noted within the cyst. The cyst wall along with contents was excised and sent for histopathological examination and microbiology analysis. Microbiological analysis revealed fungal filaments (Aspergillus fumigatus). Histopathological examination confirmed cyst wall with fungal colonies. Postoperatively, the patient is doing well without any evidence of recurrence at a follow-up period of 6 months.