Inverted papilloma of the conjunctiva

We encountered inverted papilloma of the conjunctiva in three cases. To the best of our knowledge, this tumor, which typically involves the nose, paranasal sinuses, and lacrimal sac, has not been described previously in the conjunctiva. Two of the tumors occurred as purely inverted lesions of the inner canthal region )caruncle and plica) and the third as a mixed inverted-exophytic papilloma over the tarsus. Melanotic pigmentation in one of the lesions was clinically confused with malignant melanoma. Because of the high incidence of recurrence of these tumors in the sinuses and lacrimal sac, and their unknown biologic behavior in the conjunctiva, inverted papillomas should be removed completely and the patients carefully observed.