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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:225-230 • 0278-4297

Case Series

Congenital Dacryocystocele

Prenatal 2- and 3-Dimensional Sonographic Findings

Waldo Sepulveda, MD, Adriana B. Wojakowski, MD, Diego Elias, MD, Lucas Otaño, MD and Jorge Gutierrez, MD

Fetal Medicine Center, Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile (W.S.); Fetal Medicine Unit, San Jose Hospital, University of Santiago de Chile, Santiago, Chile (W.S., J.G.); and Department of Diagnostic Imaging (A.B.W., D.E.) and Fetal Diagnosis and Therapy Unit (A.B.W., D.E., L.O.), Hospital Italiano, Buenos Aires, Argentina.

Address correspondence and reprint requests to Waldo Sepulveda, MD, Fetal Medicine Center, Clinica Las Condes, Casilla 208, Santiago 20, Chile. E-mail: waldosep{at}hotmail.com

Objective. The purpose of this series is to present our experience with cases of dacryocystocele diagnosed prenatally. The role of prenatal 3-dimensional sonography, as an adjunct to 2-dimensional sonography, in the prenatal assessment of these cases is emphasized. Methods. A retrospective review of cases was conducted. Information was obtained by reviewing the sonographic reports and medical records. Outcomes were obtained from the referring obstetricians or directly from the parents. Results. Ten fetuses had the diagnosis of a congenital dacryocystocele at a median gestational age of 30.1 weeks (range, 27–33 weeks). In 6 cases, the cystic lesion was unilateral, and in 4 it was bilateral, with a mean largest diameter at the time of diagnosis of 7.5 mm (range, 4–11 mm). There were no other associated findings. Three-dimensional sonography, carried out in 3 cases, clearly depicted the anomaly, the degree of intranasal extension, and swelling below the medial canthal area. Spontaneous resolution was documented prenatally in 5 fetuses, and 1 additional case resolved between the last prenatal scan and the delivery. There were no reported long-term complications associated with this finding, although 1 infant required probing at 2 months of age to resolve the dacryocystocele. Conclusions. Prenatal diagnosis of dacryocystocele is straightforward. A considerable number of lesions are bilateral, and many resolve in utero spontaneously or neonatally after minimal intervention. For those not resolving by the time of the delivery, ophthalmologic or rhinologic consultation is warranted because of potential complications. Three-dimensional sonography may provide a noninvasive method for evaluating these cystic masses and may contribute to the avoidance of additional diagnostic techniques in the neonatal period.

Key Words: dacryocystocele • prenatal diagnosis • prenatal sonography • 3-dimensional sonography

Abbreviations: 3D, 3-dimensional • 2D, 2-dimensional

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Copyright © 2005 by the American Institute of Ultrasound in Medicine.