J Korean Ophthalmol Soc.  2019 Jul;60(7):692-695. 10.3341/jkos.2019.60.7.692.

A Lacrimal Punctal Keratinizing Cyst of the Lower Lid

• Kang TS
• Lee YH
• Lee SB

• KMID: 2453021
• DOI: http://doi.org/10.3341/jkos.2019.60.7.692

Abstract

PURPOSE
We report an unusual case of a keratinizing cyst on the lacrimal punctum.
CASE SUMMARY
A 49-year-old female presented with an outpouching punctal mass at the left lower lid that occurred a week prior to her visit. Histopathological examination revealed a cyst filled with keratin arranged in lamina and surrounding the bacterial colony. The epithelial wall was composed of multilaminar, keratinizing squamous epithelium without goblet cells. The features were consistent with a keratinizing cyst. There was no recurrence at 4 months after the excision, and the punctum was patent.
CONCLUSIONS
Keratinizing cyst should be considered as a differential diagnosis of the cystic mass of the punctum. Because it has an excellent prognosis after surgical resection, complete resection should be performed if a keratinizing cyst is suspected.

Keyword

Keratinizing cyst; Lacrimal punctum

MeSH Terms

Diagnosis, Differential
Epithelium
Female
Goblet Cells
Humans
Lacrimal Apparatus
Middle Aged
Prognosis
Recurrence

Figure

• 

  Figure 1 The keratinizing cyst of the left lower lid. (A) A photograph of the left lower eyelid showing a 2 mm, tense, whitish, non-vascular, smooth, cystic, dome-shaped mass at the region of lower punctum. (B) The epithelium was multilayered and showed a regular basaloid germinal layer without any goblet cells or any granular layer. Microphotograph showed keratin fibers on the stratified squamous epithelium (Haemotoxylin and Eosin [H&E] stain, ×400). (C) Microphotograph of the cystic content showing central bacterial colony (arrow) and surrounding keratin fibers arranged in laminar and wavy patterns (H&E stain, ×40). (D) There was no recurrence after 4 months.

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