Invasive Transitional Cell Carcinoma of the Lacrimal Sac Arising in an Inverted Papilloma

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Abstract
Tumors of the lacrimal sac are infrequently reported owing to their low incidence. Transitional cell carcinomas are exceedingly rare.1 We describe herein a patient with a lacrimal sac tumor whose initial biopsy specimen showed an inverted papilloma. Examination of the excised mass 2 months later, however, revealed transitional cell carcinoma arising within an inverted papilloma. Report of a Case. A 36-year-old white man complained of a left medial canthal mass associated with epiphora of 4 months' duration. Examination revealed a nontender, firm, elevated mass above and below the left medial canthal tendon. Irrigation revealed a high-grade obstruction distal to the common internal canaliculus. There was no purulent or serosanguineous discharge. A dacryocystorhinostomy was attempted. During surgery, a solid tumor was found within the nasolacrimal sac, which appeared to be contiguous with the nasal cavity. The nasal mucosa, therefore, was not opened to complete the rhinostomy. Histologically, this tumor was

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