EP07.37: Prenatal diagnosis of unilateral dacryocystocele: a case report

Dacryocystocele, characterised by the dilation of the lacrimal sac due to obstruction, is a relatively rare condition, particularly when diagnosed prenatally. This case report details the prenatal identification of a unilateral dacryocystocele via third trimester ultrasonography, delineating its diagnostic features, the implications for further investigations, prognosis, and the subsequent counselling and management. A 32-year-old primigravida presented for routine prenatal care, where a third trimester ultrasound revealed a unilateral cystic structure in the left orbit of the fetus. Subsequent diagnostic imaging confirmed the presence of a dacryocystocele, characterised by an anechoic or hypoechoic cystic lesion exceeding 5mm on the medial canthal region with associated intraorbital extension. The rarity of prenatal dacryocystocele diagnoses—scarcely reported in the literature—highlights the need for the sonographic criteria review for a precise differential diagnosis, which include a variety of orbital masses and cystic lesions. Critical parental counselling was conducted, elucidating the typically benign nature of the condition, while addressing the potential for acute complications such as respiratory distress due to nasolacrimal duct obstruction at birth. The case underscores the critical role of awareness and prompt recognition of dacryocystocele in prenatal ultrasounds and advocates for a structured and proactive postnatal management protocol, necessitating a collaborative healthcare approach to ensure optimal neonatal outcomes. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.