A Lacrimal Punctal Keratinizing Cyst of the Lower Lid

Tae-Seen Kang; Yeon-Hee Lee; Sung Bok Lee

doi:10.3341/jkos.2019.60.7.692

Journal List > J Korean Ophthalmol Soc > v.60(7) > 1129794

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Kang, Lee, and Lee: A Lacrimal Punctal Keratinizing Cyst of the Lower Lid

Case Report

Journal of the Korean Ophthalmological Society 2019; 60(7): 692-695.

Published online: 15 July 2019

DOI: https://doi.org/10.3341/jkos.2019.60.7.692

A Lacrimal Punctal Keratinizing Cyst of the Lower Lid

Tae-Seen Kang, MD, Yeon-Hee Lee, MD, PhD, Sung Bok Lee, MD, PhD

Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.

Address reprint requests to Sung Bok Lee, MD, PhD. Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: 82-42-280-7604, Fax: 82-42-255-3745, sblee@cnu.ac.kr

Received 8 November 2018 Revised 20 November 2018 Accepted 20 June 2019

The Korean Ophthalmological Society

(open-access):

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

We report an unusual case of a keratinizing cyst on the lacrimal punctum.

Case summary

A 49-year-old female presented with an outpouching punctal mass at the left lower lid that occurred a week prior to her visit. Histopathological examination revealed a cyst filled with keratin arranged in lamina and surrounding the bacterial colony. The epithelial wall was composed of multilaminar, keratinizing squamous epithelium without goblet cells. The features were consistent with a keratinizing cyst. There was no recurrence at 4 months after the excision, and the punctum was patent.

Conclusions

Keratinizing cyst should be considered as a differential diagnosis of the cystic mass of the punctum. Because it has an excellent prognosis after surgical resection, complete resection should be performed if a keratinizing cyst is suspected.

Keywords: Keratinizing cyst, Lacrimal punctum

Figures and Tables

Figure 1

The keratinizing cyst of the left lower lid. (A) A photograph of the left lower eyelid showing a 2 mm, tense, whitish, non-vascular, smooth, cystic, dome-shaped mass at the region of lower punctum. (B) The epithelium was multilayered and showed a regular basaloid germinal layer without any goblet cells or any granular layer. Microphotograph showed keratin fibers on the stratified squamous epithelium (Haemotoxylin and Eosin [H&E] stain, ×400). (C) Microphotograph of the cystic content showing central bacterial colony (arrow) and surrounding keratin fibers arranged in laminar and wavy patterns (H&E stain, ×40). (D) There was no recurrence after 4 months.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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