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CASE REPORT
Year : 1983  |  Volume : 31  |  Issue : 2  |  Page : 87-88

Fibrous histiocytoma of the lacrimal sac (A case report)


Regional Institute of Ophthalmology, Medical College, Calcutta, India

Correspondence Address:
I S Roy
Director, Regional Institute of Ophthalmology, Medical College, Calcutta-700073
India
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Source of Support: None, Conflict of Interest: None


PMID: 6319277

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How to cite this article:
Das A, Chowdhury S, Mitra J N, Sengupta P, Roy I S. Fibrous histiocytoma of the lacrimal sac (A case report). Indian J Ophthalmol 1983;31:87-8

How to cite this URL:
Das A, Chowdhury S, Mitra J N, Sengupta P, Roy I S. Fibrous histiocytoma of the lacrimal sac (A case report). Indian J Ophthalmol [serial online] 1983 [cited 2020 Nov 27];31:87-8. Available from: https://www.ijo.in/text.asp?1983/31/2/87/27447

Fibrous histiocytoma is a rare tumour either with a benign or malignant course. It is more commonly found in the Orbit[1],[2],[3], and the other less frequent sites are conjunctiva[4], tarsus[5] and ciliary body[6]. So far three cases of histiocytoma of the lacrimal sac have been reported in the literature[7],[8]. Here one more similar case is reported.


  Case report Top


A 38 year-old male. S.B.. complained of watering in the right eye for one year and a half, and also of a slowly progressing swell­ing in the region of the right lacrimal sac for the last six months.

On examination of his right eye, there was no conjunctiva) congestion. The eyeball was normal and the visual acuity was 6/6. A swel­ling of 10 mm x 15 mm was found in the region of the right lacrimal sac. It was non­tender and firm in consistency. On pressure over the swelling there was slight mucous re­gurgitation from the lower punctum. The syringing done on several occasions showed that the right naso-lacrimal passage was partially patent. The patient was treated with topical sodium sulfa-acetamide and chloram­phenicol drops but with no effect.

The patient was admitted as a case of right-sided mucocele for dacryocystorhinosto­my (DCR) operation, if possible. After the skin incision, a tense, brown firm swelling tinder the expanded medial palpebral liga­ment was found. It was well encapsulated and the whole mass was separated easily from the surrounding tissues. The thick­walled capsulated mass was sent for histopa­thological examination. The mass was 8 mm X 12 mm x 10 mm. in size.

Pathological examination

The excised mass was fixed, processed, sectioned and stained with hematoxylin and eosin. Bands of spindle cells often arranged in a storiform pattern were the presenting feature. There were also scattered histiocytes with abundant cytoplasm and foam cells. No mitoses were found in the cells. The histologi­cal diagnosis was benign fibrous histiocytoma of the lacrimal sac [Figure - 1][Figure 2].


  Discussion Top


The studies of Kauffman and Stout[9] have shown that fibrohistiocytoma originates from the histiocyte cell. They suggested that the pluripotency of the histiocyte might be re­sponsible for the variation of the cellular type and fibrous tissue in such tumours. So, they designated tumours with predominantly cellular components as histiocytomas and those with predominantly fibrous components as fibroxanthomas. Recently Fu et al[10] con­sidered the primitive mesenchyme cell to be the cell of origin of fibrohistiocytorna.

Rarely, fibrohistiocytomas may take a malignant course. In a series of 1516 patients with fibrohistiocytoma, O' Brien and Stout[11] found only 1 % cases to be malignant.

Fibrohistiocytoma commonly involves the orb it[1],[2],[3], sub Cases of involvement of conjunctiva and ciliary body[4], tarsus[5], corneoscleral limbus[12] and conjunctiva[6], although rare, have been reported. The incidence of fibro­histiocytoma of the lacrimal sac is extremely rare, first reported by Cole and Ferry[7] in 1978. Recently two additional cases have been described by Marback et al[8]. No case of histiocytoma of the lacrimal sac has been previously reported from India.

Before operation, it was never thought to be a case of lacrimal sac tumour and so a DCR aperation was planned. But it was only after exposure it was decided a dacryocvs­tectomy to be performed, and to the surprise, the histopathological examination of the mass revealed a fibrous histiocytoma of the lacri­mal sac.


  Summary Top


A rare case of fibrous histiocytoma of the lacrimal sac has been reported.

 
  References Top

1.
Jakobiec, F.A., Howard, G.M.. Jones, I.S. and Taunebaum. M., 1974, Amer. J. Ophthalmol. 77:333  Back to cited text no. 1
    
2.
Rodrignes, M.M., Furginelie. F.P. and weinreb, S., 1977, Arch. Ophthalmol. 95: 2025  Back to cited text no. 2
    
3.
Biedner, B. and Rothhoff, L. 1978, Amer. J. Ophthalmol 80: 548  Back to cited text no. 3
    
4.
Alber, D.M. and Smith. R.S. 1968, Arch. Ophthalmol, 80:474  Back to cited text no. 4
    
5.
Jakobiec. F.A., Devoe A.G. and Boyd, J., 1977, Amer J. Ophthalmol. 84 : 794.  Back to cited text no. 5
    
6.
Delgrado-partida, P.& Rodrignez-Trujillo, F., 1912, Amer. J. Ophthalmol. 74: 479.  Back to cited text no. 6
    
7.
Cole. S.H. and Ferry, A.P., 1978, Arch. Ophthalmol,. 96 : 1647.  Back to cited text no. 7
    
8.
Marback. R.L., Kincaid. M.C., Green, W.R. and Miff, W.J., 1982. Amer. J. Ophthalmol. 93 511  Back to cited text no. 8
    
9.
Kauffmam, S. L. and Stout, A.P. 1961. Cancer, 14:49  Back to cited text no. 9
    
10.
Fu, Y.S., Gabbiani, G.. Kaye, G.I. and Lattes, R.. 1975, Cancer. 35 : 176.  Back to cited text no. 10
    
11.
O'Brien, J.E. and Stout, A.P., 1964, Cancer, 17 : 1445.  Back to cited text no. 11
    
12.
Faludi. J.E.. Ken yen. 80 K. and Green. W.R.. 1975, Amer. J. Ophthalmol. 80 : 619.  Back to cited text no. 12
    


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