International Journal of Otorhinolaryngology and Head and Neck Surgery | March-April 2019 | Vol 5 | Issue 2 Page 517 International Journal of Otorhinolaryngology and Head and Neck Surgery Kumar SS et al. Int J Otorhinolaryngol Head Neck Surg. 2019 Mar;5(2):517-519 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Case Report Lacrimal sac rhinosporidiosis mimicking soft tissue sarcoma: a case report S. Sathish Kumar 1 , N. T. Sreedevi 2 *, Aarudhra Premchander 3 INTRODUCTION Rhinosporidiosis is a granulomatous disease caused by Rhinosporidium seeberi, usually presenting as polypoidal growth involving the nasal mucosa and nasopharynx. 1 It rarely affects other sites like lacrimal sac, tonsils and the skin. The disease is endemic in India (especially in Tamil Nadu) and Sri Lanka. 1 We present a case of rhinosporidiosis involving lacrimal sac and the overlying skin. CASE REPORT A 58 year old gentleman presented to the department of otorhinolaryngology, VIMS and RC, with complaints of right infraorbital painless, insidious onset and progressive swelling of one year duration. For the same swelling he had undergone endoscopic dacrocystorhinostomy (DCR) under general anesthesia four months prior to the presentation. However seven days after the surgery the swelling increased in size to the extent of 5×8 cm (vertical and horizontal respectively). He also had noticed right nasal discharge on pressure over the swelling. He did not suffer from nose block, nose bleed, decreased sense of smell, excess watering of right eye, ear or throat related symptoms. He had never sustained trauma to facial structures. He had no comorbid conditions except for systemic hypertension for three years for which he was on regular medications. On examination he had normal vitals and general physical examination did not reveal any clinical abnormalities. Thorough ENT examination was carried out. Anterior rhinoscopy showed deviated nasal septum to right with spur with left inferior turbinate hypertrophy. Diagnostic nasal endoscopy showed mulberry nodule at the level of axilla of right middle turbinate. Synechae observed between nasal septum and right middle turbinate. Ears and throat were normal. A soft solitary non-tender, non-pulsatile, non-reducible but compressible swelling of 5×8 cms was noted sagging down in the right infra-orbital region extending vertically from lower eyelid down to the level of right ala of the nose. The swelling extended horizontally from the lacrimal sac area to the lateral canthus. There was Pau-de-orange appearance of lower portion of skin over the swelling. Ophthalmic examination was normal except for the above mentioned swelling in infraorbital region. ABSTRACT Rhinosporidiosis is a granulomatous disease caused by Rhinosporidium seeberi, usually affecting the nasal mucosa. Involvement of other sites of body in rhinosporidiosis especially, the lacrimal sac involvement is very rare. Hence, we report a case of lacrimal sac rhinosporidiosis in an adult male patient who presented with infraorbital swelling. Keywords: Rhinosporidiosis, Lacrimal sac, Sporangium 1 Department of ENT, 3 Department of Surgery, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bangalore, Karnataka, India 2 Department of ENT, Mysore Medical College, Mysuru, Karnataka, India Received: 23 December 2018 Revised: 03 February 2019 Accepted: 04 February 2019 *Correspondence: Dr. N. T. Sreedevi, E-mail: sreedevint8@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20190790