A Case of Canaliculocele Treated with Punctoplasty and Marsupialization

Kwan Hyuk Cho; Mi Jung Kwon; Min Joung Lee

doi:10.3341/jkos.2014.55.6.898

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Cho, Kwon, and Lee: A Case of Canaliculocele Treated with Punctoplasty and Marsupialization

Case Report

J Korean Ophthalmol Soc 2014;55(6):898-901.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.898

A Case of Canaliculocele Treated with Punctoplasty and Marsupialization

Kwan Hyuk Cho, MD¹, Mi Jung Kwon, MD², Min Joung Lee, MD¹

¹Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

²Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

Address reprint requests to Min Joung Lee, MD, Department of Ophthalmology, Hallym University Sacred Heart, Hospital, #22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 431-796, Korea, Tel: 82-31-380-3834, Fax: 82-31-380-3833, E-mail: tweeti2@hanmail.net

Received 13 December 2013 Revised 8 January 2014 Accepted 15 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Canaliculocele is a rare cause of eyelid mass which is formed by dilation of the canaliculus. We introduce a case of ca-naliculocele treated with punctoplasty and marsupialization.

Case summary:

A 35-year-old woman visited our clinic complaining of a right medial upper eyelid mass. It started 3 months ago and had the wax and wane feature. On slit lamp examination, cystic lesion was visible in the medial area of the right upper eyelid, and the punctum was obscure. Right upper canaliculus was not shown in dacryocystography. One-snip punctoplasty was per-formed for the diagnosis, and turbid contents were drained leading to collapse of the cyst. After diagnosis of canaliculocele, mar-supialization was added by excision of the posterior wall of the mass. On histopathologic examination, the cystic wall was com-posed of nonkeratinized squamous epithelium with an attenuated superficial cell layer. The patient healed without recurrence of a cyst after 6 months of follow up.

Keywords: Canaliculocele, Marsupialization, Medial canthal mass

References

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Figure 1.

(A) External photograph at initial visit shows a bulging mass at the medial part of right upper eyelid (white arrows). (B) At 1month after surgery, there is no evidence of recurrence. (C) Anterior segment photograph shows a mass at infrapunctal subcon-junctival area (black arrow heads). (D) The mass is well-transilluminated with silt beam and punctal obstruction is also visible (black arrow). (E) Postoperative 6 months, the cyst is not recurred and punctual opening is well visible (white arrow).

Figure 2.

Microscopic appearance of canaliculocele. (A) Longitudinal portion of canaliculocele wall. The cystic wall is composed of nonkeratinizing squamous epithelium with attenuated and flat superficial layer. The basilar germinal cells preserve the character-istic picket fence regimentation (Hematoxylin-eosin, x400). (B) Cytokeratin 7 stains the superficial layer of the epithelium (x400). (C) Cytokeratin 20 is totally negative (x400).

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