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Case Reports
. 2025 Jul 25;17(7):e88755.
doi: 10.7759/cureus.88755. eCollection 2025 Jul.

Synchronous Sinonasal Inverted Papilloma With Nasolacrimal Squamous Cell Carcinoma: An Uncommon Case Report of Malignant Transformation of Inverted Papilloma

Julide Kasaboglu  1 , Stoyan Dimitrov  2 , Milena Mitkova  2 , Spiridon Todorov  2 , Tsvetomir Marinov  3
Affiliations
Case Reports

Synchronous Sinonasal Inverted Papilloma With Nasolacrimal Squamous Cell Carcinoma: An Uncommon Case Report of Malignant Transformation of Inverted Papilloma

Julide Kasaboglu et al. Cureus. .

Abstract

Nasolacrimal tumors are exceedingly rare head and neck pathologies. They are locally invasive and have an increased possibility of aggressive malignant transformation. These tumors are clinically presented with a palpable mass, obstruction of nasolacrimal drainage, epiphora, and nasal congestion. Nasolacrimal carcinomas are rare malignancies that often take a long time before the correct diagnosis is made. The combination of endoscopic and open en-bloc resection can provide complete removal of locally advanced nasolacrimal tumors. A multidisciplinary team, chemo-radiotherapy, and follow-up monitoring are essential for the effective management of such tumors. We report a case of a 41-year-old male patient with presentation of epiphora and a paranasal lump. Imaging showed an advanced nasolacrimal tumor with infiltration of surrounding structures. Pathologic examination demonstrated nasolacrimal keratinizing squamous cell carcinoma (SCC) associated with sinonasal inverted papilloma. A multidisciplinary approach, including radical surgery and chemo-radiotherapy, rendered success in achieving remission with a four-year disease-free follow-up.

Keywords: inverted papilloma; lacrimal sac; malignancy; nasolacrimal duct system; sinonasal; squamous cell carcinoma.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This research is supported by the Bulgarian Ministry of Education and Science under the National Programme "Young Scientists and Postdoctoral Students-2". Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Computer tomography (CT) scan of the paranasal cavities
L-left; R-right Tumor infiltration with bone destruction of the medial wall of the maxillary sinus, the frontal process of the maxillary bone, and the medial wall of the orbit, on the right side. The nasal septum was severely compressed and displaced by the tumor mass contralaterally.
Figure 2
Figure 2. Sagittal view of CT scan of the head
The right side of the nasal cavity was filled with tumor mass, which displaced the septum to the left.
Figure 3
Figure 3. Part of the endoscopic resection of the advanced nasolacrimal tumor with infiltration of surrounding structures.
See this image and copyright information in PMC

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