A newborn infant presents with the condition shown. Which one of the following statements is least accurate with regard to the condition
|A.||Differential diagnosis includes hemangioma, encephalocele, and dermoid cyst.|
|B.||Patients present with significant retrograde discharge into the eye.|
Swelling is caused by trapped amniotic fluid.
This condition can be associated with respiratory compromise
Answer: B. Patients present with significant retrograde discharge into the eye.
Explanation: The photograph demonstrates a dacryocystocele. This uncommon condition presents at birth with swelling below the medial canthal ligament. Differential diagnosis includes hemangioma, encephalocele, and dermoid cyst, which are more commonly seen above the medial canthal ligament. A membranous blockage over the valve of Hasner leads to lacrimal sac distention, which secondarily closes off entry to the sac from the common canaliculus. Retrograde discharge is blocked by the physiologic obstruction. At birth, the dacryocystocele often contains trapped amniotic fluid. Associated nasal mucoceles seen with this condition can result in significant respiratory compromise.