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Case Report Plastic and Aesthetic Research

Lacrimal sac rhinosporidiosis

Laxmi Kanta Mishra , Sanjeev Gupta , Surya Kanta Pradhan , Manas R. Baisakh 3
1
2
2
1 Department of Plastic Surgery, Apollo Hospitals, Bhubaneswar 751005, Orissa, India.
2 Department of ENT ‑ Head Neck Surgery, Apollo Hospitals, Bhubaneswar 751005, Orissa, India.
3 Department of Pathology, Apollo Hospitals, Bhubaneswar 751005, Orissa, India.
Address for correspondence: Dr. Laxmi Kanta Mishra, Department of Plastic Surgery, Apollo Hospitals, Bhubaneswar 751005, Orissa, India.
E-mail: drlkmishra@rediffmail.com

ABSTRACT
Rhinosporidiosis is caused by the organism Rhinosporidium seeberi. It is a rare aquatic protistan parasite.
Though more prevalent in Asiatic regions, cases have also been reported in European countries. In
India, it mostly affects the southern part. Rhinosporidium seeberi most commonly affects the mucous
membranes, but can also affect other structures including the larynx, trachea, skin, genitalia, lungs and
rectum. The typical presentation is that of a pinkish mass which bleeds profusely. Isolated lacrimal
sac rhinosporidiosis is very rare. Computed tomography scans and magnetic resonance imaging are
helpful in diagnosis, but histopathological study along with Gomori methenamine silver, periodic
acid-Schiff, and potassium chloride are required for confirmation. Its mainstay of treatment is surgery.
Prognosis is excellent, but recurrence is not unusual.

Key words:
Computed tomography scan, lacrimal sac, Rhinosporidium seeberi, rhinosporidiosis

INTRODUCTION CASE REPORT

Rhinosporidiosis is a chronic granulomatous disease A 20‑year‑old man presented with swelling at the medial
affecting the mucous membrane primarily. It is caused by canthus of the left eye. He had experienced epiphora for
Rhinosporidium seeberi. Previously thought to be a fungus, a period of 6 months prior to presentation. There was
[1]
it is now believed to be a rare aquatic protistan parasite. no history of pain, trauma, bleeding, fever or nasal
Rhinosporidiosis is endemic in South India, Sri Lanka, obstruction. On examination, his general condition was good.
South America and Africa. The most common route of There was a soft, nontender, diffuse swelling of 4 cm × 2 cm
transmission is exposure to the pathogen while bathing in over the medial canthus of the left eye. Syringing of the
stagnant water pools. It usually presents as a pinkish mass lacrimal system was performed and was remarkable for
in nose, nasopharynx, oropharynx, conjunctiva, rectum obstruction of the lacrimal sac. The remainder of the
and external genitalia with symptoms depending on the ocular examination was normal. Nasal endoscopy and
site. Isolated lacrimal sac involvement is very rare. The examination of the oropharynx were normal. Routine
mainstay of treatment is surgical excision. The authors hematological investigations were normal. Serial axial
present a case of isolated lacrimal sac rhinosporidiosis sections of the paranasal sinuses were performed using
with its surgical management. The patient involved in computed tomography (CT). Multi‑plane reconstructions
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How to cite this article: Mishra LK, Gupta S, Pradhan SK,
Baisakh MR. Lacrimal sac rhinosporidiosis. Plast Aesthet Res
DOI:
10.4103/2347-9264.169501 2015;2:353-6.
Received: 16-05-2015; Accepted: 13-10-2015

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