A A JH Jang, et al. A SCHNEIDERIAN PAPILLOMA OF THE LACRIMAL SAC B B Fig. 2. Orbital MRI before surgery. (A) A well-defined mass lesion (arrow) at the right lacrimal sac (T2WI, sagittal view, fat saturation enhancement). (B) A heterogeneous enhancementin the lesion that extends anteriorly adjacent to the right facial soft tissues without evidence of bony structure destruction (T1WI, axial view, Gadolinium enhancement). Fig. 3. Orbital MRI, 3 months after surgery. (A) A small enhancing recurred lesion (thick arrow) is seen in the right nasolacrimal sac (T1WI, axial view, Gadolinium enhancement). (B) A recurred mass (thin arrow) invading the nasal cavity via the inferior meatus (T1WI, coronal view, Gadolinium enhancement). cavity via the inferior meatus (Fig. 3). After referral to the Department of Otorhinolaryngology, the patient underwent endoscopic biopsy of the nasal cavity lateral wall through a nasal approach. An identical tumor was confirmed, and endoscopic medial maxillectomy and dacryocystorhinostomy has been planned for its removal. Histopathology findings Histological examination revealed a fungiform mass with projecting finger-like proliferation of the epithelium. The tumor revealed an exophytic growth pattern with branching fibro- vascular stalks covered by an epithelial cell layer (Fig. 4). According to the cytological features, the lesion was a transi- 101