Localized orbital amyloidosis involving the lacrimal sac and nasolacrimal duct

Purpose: To report the case of a 70-year-old man who presented with tearing in his left eye and a firm palpable lump in the area overlying his left lacrimal sac. Design: Retrospective interventional case report. Methods: Noninvasive diagnostic evaluation followed by external dacryocystorhinostomy, histopathologic studies, and systemic evaluation. Results: The patient was found to have idiopathic localized amyloidosis limited to the lacrimal sac and nasolacrimal duct. Conclusion: The localized form of amyloiclosis is rare, typically involves the head and neck without systemic manifestations, and carries an excellent prognosis. Previous reports of orbital amyloiclosis have described involvement of the lacrimal gland, extraocular muscles, and the cranial nerves. To our knowledge, this is the first report of a patient with nasolacrimal duct obstruction secondary to amyloid deposition in the lacrimal sac and fossa.