Case Study: June 2007


A 35 year old woman presents with epiphora and a bony mass around the naso-lacrimal duct. The bony lesion had a classical X-ray appearance.

At DCR, the bony lesion was debulked and sent for histology.

Figures are H and Es.

What is the diagnosis?

Click to show answers

Irregular woven bone, without osteoblastic rimming within a spindle cell stroma. No cellular atypia or mitotic activity was identified. The spindle cell stroma appears to dissect the woven bone.

This is fibrous dysplasia affecting the lacrimal sac fossa. In this case it was monostotic.

Zodpe P, Chung SW, Kang HJ, Lee SH, Lee HM. Endoscopic treatment of nasolacrimal sac obstruction secondary to fibrous dysplasia of paranasal sinuses.
Eur Arch Otorhinolaryngol. 2007 May;264(5):495-8

McCluskey P, Wingate R, Benger R, McCarthy S.
Monostotic fibrous dysplasia of the orbit: an unusual lacrimal fossa mass.
Br J Ophthalmol. 1993 Jan;77(1):54-6.
Moore AT, Buncic JR, Munro IR. Fibrous dysplasia of the orbit in childhood. Clinical features and management.Ophthalmology. 1985 Jan;92(1):12-20.