Solitary Sclerotic Fibroma as a Rare Cause of Nasolacrimal Duct Obstruction

Abstract

Purpose: To report a case of solitary sclerotic fibroma (SF) as a rare cause of nasolacrimal duct obstruction. Methods: A 47-year-old female presented with a mass in the right lacrimal sac region that was associated with intermittent watering, pain and itching, and showed delayed fluorescein clearance. CT scan showed a soft tissue density in the lacrimal sac region. The mass was completely excised and on histopathology showed a well-circumscribed fibrous nodule with eosinophilic collagen bundles arranged in an interweaving “plywood” pattern with elongated clefts between them, characteristic of SF. Conclusions: SF should be included in the differential diagnosis of nodular masses in the lacrimal sac region. Although most of SFs occur in the dermis and are asymptomatic, this case suggests that SF can produce symptoms and signs of clinical significance by virtue of its anatomic location in a confined space in proximity to other structures.