Endoscopic Resection of a Rare Inverted Papilloma Involving the Lacrimal Duct and Sac

Inverted papilloma (IP) is a benign epithelial tumor. Most cases occur unilaterally in males in their 60s to 70s. Extension into the lacrimal duct or sac is uncommon and presents diagnostic challenges due to overlapping symptoms with more common conditions, such as dacryocystitis. Their nonspecific presentation may lead to delayed or incorrect diagnosis. Preoperative imaging, such as CT or MRI, is essential for determining tumor extent. Complete surgical excision, often achieved through endoscopic approaches, is the gold standard for treatment and minimizes the risk of recurrence. We present the case of a 58-year-old male with a 5-year history of a progressively enlarging medial left lower eyelid mass, epiphora, and occasional bloody discharge. The patient had a history of nasal polyposis, with two prior surgeries for nasal polyp removal. Examination revealed a medial canthal mass without infection. Our team performed a biopsy at the outpatient clinic, and histopathology confirmed the diagnosis of IP. The patient underwent a left dacryocystorhinostomy with tumor resection. We completed the procedure without complications. This case highlights the importance of considering IP in the differential diagnosis of medial canthal masses with epiphora. Prompt recognition and effective surgical management are crucial for preventing recurrence and optimizing outcomes.