Sinonasal (Schneiderian) papilloma of the lacrimal sac.

Sinonasal papillomas, also known as Schneiderian papillomas, are benign but infiltrative epithelial neoplasms that arise from ectodermally derived pseudostratified ciliated (or Schneiderian) epithelium that lines the sinonasal tract and nasal cavity. We describe a rare case of a sinonasal papilloma confined to the lacrimal duct and sac in a 45-year-old man who presented with 10 months of right-sided epiphora and swelling of his medial right lower eyelid. He was found to have a 10 × 10 mm area of distension near the right lacrimal sac and underwent an external dacryocystorhinostomy. A computed tomography scan revealed an expansile mass in the right nasolacrimal duct area. Right endoscopic sinus surgery and endoscopic dacryocystorhinostomy were performed. This case illustrates the importance of including sinonasal papilloma, a benign but invasive neoplasm, in the differential diagnosis of nasolacrimal duct obstruction.