Dear Colleagues!

A patient of mine had a tumor of the nasolacrimal duct. CT and MRI scans conclusion was a nasolacrimal duct polyp. I performed endonasal DCR, no neoplasm inside the duct, but the wall was strangely solid and with corkscrew-shaped vessels. I took the lateral wall of a nasolacrimal duct for biopsy.

Histopathological conclusion: a fragment of a mucose membrane, covered with cubical epithelium with mucous glands, with underlying mixomatous stroma, fragments of vessels with thickened walls (cavernous vessels). Morphological pattern is highly suspicious of belonging to cavernous hemangioma.

But: 1) intraoperatively it didn’t look like CH; 2) as far as I know, cavernous vessels are normal for nasolacrimal duct.

Could you help me with the diagnosis? Any cases of CH of nasolacrimal duct in your practice?

Kind regards,

Vasily Yartsev, MD