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AJNR - American Journal of Neuroradiology

Published ahead of print on October 5, 2007
doi: 10.3174/ajnr.A0709

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American Journal of Neuroradiology 28:1872-1875, November-December 2007
© 2007 American Society of Neuroradiology

HEAD & NECK

Imaging Characteristics of Dacryocystocele Diagnosed after Surgery for Sinonasal Cancer

J.M. Debnam^a, B. Esmaeli^b and L.E. Ginsberg^a

^a Department of Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, Tex
^b Section of Ophthalmology, The University of Texas M.D. Anderson Cancer Center, Houston, Tex

Please address correspondence to J. Mathew Debnam, MD, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 370, Houston, TX; e-mail: matthew.debnam{at}mdanderson.org

BACKGROUND AND PURPOSE: A dacryocystocele forms when tears accumulate within the lacrimal sac as a result of an obstruction more distally in the lacrimal drainage apparatus, which may occur as a complication of sinonasal surgery. The purpose of this study was to define the imaging characteristics of a postoperative dacryocystocele occurring after surgery for sinonasal cancer and to review the anatomy of the nasolacrimal drainage apparatus.

MATERIALS AND METHODS: We reviewed the clinical records and imaging findings of 8 patients who underwent surgery for sinonasal cancer and were diagnosed with a postoperative dacryocystocele between August 2001 and November 2005. The imaging studies performed at the time of diagnosis of dacryocystocele were CT in 6 patients and MR imaging in 2 patients.

RESULTS: On both CT and MR imaging, dacryocystoceles had a characteristic appearance of a fluid collection with thin rim enhancement along the course of the affected nasolacrimal duct, with no adjacent solid components. In none of the patients was the dacryocystocele confused with a recurrent tumor.

CONCLUSION: Dacryocystocele after surgery for sinonasal cancer has a characteristic appearance on CT and MR imaging. Familiarity with this complication of sinonasal surgery and its appearance on imaging will enable radiologists to avoid misinterpreting dacryocystocele as a recurrent tumor or another process.