Lacrimal Sac Actinomycosis: A Masquerade of Lacrimal Sac Malignancy

A 60-year-old woman had blood-stained discharge with intermittent hemolacria from the left eye, of 3 months duration. The ophthalmic examination showed a firm, nontender, and immobile mass in the left lacrimal sac region. The sac regurgitation test was positive with purulent blood-stained discharge. Lacrimal punctum and canaliculi of both sides were normal. CT scan of orbits showed a hyperdense lesion in the left lacrimal sac region without bone erosion. A complete dacryocystectomy was performed, and the histopathology revealed actinomycosis of the lacrimal sac. At 14 months of follow-up visit, the patient has no clinical evidence of recurrence.