# 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.

## Key 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.