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

TL;DR

A rare case of a benign nasal tumor transforming into a malignant cancer is reported, highlighting the importance of early diagnosis and multidisciplinary treatment.

Contribution

This case report presents a rare synchronous occurrence of inverted papilloma and squamous cell carcinoma in the nasolacrimal region.

Findings

The patient had a nasolacrimal keratinizing squamous cell carcinoma associated with sinonasal inverted papilloma.

A multidisciplinary treatment approach achieved remission with four years of disease-free follow-up.

The case highlights the aggressive nature and malignant transformation potential of nasolacrimal tumors.

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.

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