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Atypical Lacrimal Drainage System Granulomas Masquerading as Lacrimal Neoplasms - SALDO update study (SUP) - Paper
Nandini Bothra1, Dilip K Mishra2, Mohammad Javed Ali1
1Govindram Seksaria Institute of Dacryology, L.V Prasad Eye Institute, Hyderabad, India.
Purpose:
To report the presentation, management and outcomes of atypical cases presenting with granulomatous diseases of the lacrimal drainage system.
Methods:
Retrospective analysis of biopsy-proven cases presenting with atypical lacrimal drainage system granulomatous diseases over a study period of 2 years (August 2023 to September 2025) was performed. Demographics, clinical presentations, radiological features (CT-DCG), treatment, histopathology, immunohistochemistry, final diagnosis, and outcomes were analysed.
Results:
During the study period, five such cases were found in the database with the average age of patients being 62.4 years (range: 43-70 years). The diagnosis of the atypical lacrimal sac granulomatous diseases includes xanthogranuloma, sclerosing, and non-sclerosing variants of non-specific orbital inflammatory disease, and fungal granulomas.
Conclusions:
Atypical presentations of lacrimal sac granulomatous lesions are an uncommon occurrence and sparsely reported in the literature. They can be differentiated from malignancy based on clinical presentations, a high index of suspicion, and a confirmatory histopathological examination.
