Manifestation einer Wegenerschen Granulomatose als Tränensacktumor

Summary

History and signs This is a report on a patient, who presented an ulcerated lesion (1.5 × 1.2 cm) in the lacrimal sac area. The lesion had existed for 3 months before the patient went to an ophthalmologist. The lacrimal pathway was rinsable all the time.

Therapy and outcome The patient has was treated by antibiotics and leukase cones at first. But the lesion showed no tendency to heal under this therapy. The patient was sent to the ETN department for further investigations. At this time the suspicion of a malignant process was discussed. In the meantime the lesion became epithelialized, but no closure could be reached at any time. The CT scans showed a bone defect of 1 cm of the lamina papyracea. Tumoruos tissue passed through this defect reaching the ulcer at the medial canthal angle. A biopsy was been taken and revealed granulomatous tissue typical for a Wegener's granulomatosis. The patient was sent to an Internal medicine department, but he died one month later due to systemic disorders of this disease.

Conclusions Although an acute dacryocystitis is most often the reason for a lacrimal sac swelling and inflammation, in all cases of rinsable lacrimal pathway and long term lacrimal sac ectasy a neoplastic or a granulomatous reason has to be excluded.

Key words

Wegener's granulomatous - lacrimal sac tumour - vasculitis

Schlüsselwörter

Wegenersche Granulomatose - Tränensacktumor - Vaskulitis