Giant Dacryops in a 4-year-old Child.

A 4-year-old girl presented with 2 years of painless, intermittent left eyelid swelling with 5 days of acute worsening associated with bluish-gray skin discoloration (A). Orbital magnetic resonance imaging demonstrated a well-circumscribed, thin-walled, rim-enhancing cystic lesion arising from the left lacrimal gland (B). She underwent complete surgical excision (C). Pathology revealed a benign epithelial cyst (D, red arrow) and adjacent normal lacrimal gland tissue (D, blue arrow). The final diagnosis was dacryops. Dacryops is uncommon in children and should be considered in the differential of recurrent pediatric eyelid swelling, in addition to lymphangioma and other vascular lesions. (Magnified version of Figure A-D is available online at www.aaojournal.org).