1Grenzebach U. H., 2Stoll W., 1Busse H.

1Klinik und Poliklinik für Augenheilkunde, 2HNO-Klinik, Universitätsklinikum Münster

Papillomas of the lacrimal system are frequent findings in ophthalmological practice, especially when the conjunctiva and the canaliculi are involved. To the contrary, inverted papillomas of the lacrimal sac are are histological findings.Inverted Papillomas are locally aggressive tumors that mostly originate from sinunasal mucosa. They have a high recurrence rate of 20- 30% and a tendency to malignancy of 13 %. The detection of papillomavirus-subgroups can be helpful to consider their malignancy potential. Various therapeitic regimen range from exenteratio, resection of the facial skeleton and radiotherapy. Adequate therapy with regard to tumor extension is essential in those casews. We present two cases of inverted papilloma with extended involvement of the lacrimal system. Both patients presented with the clinical symptoms of lacrimal duct obstruction. Intraoperatively, we found an extended papillomatosis of the lacrimal sac. Therefore DCR was performed. As the histological examination revealed moderate cell dyplasia of interted papilloma, we turned to radical surgical tratment by en bloc resection of the lacrimal duct via osteoplastic lateral rhinotomy. Both patients remained free of recurrence until today. Although inverted papillomas are of benign origin their paotential of malignant transformation has to be considered in diagnostitic and therpeutic concepts.

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