Inverted Papilloma Presenting as Orbital Cellulitis and Dacryocystitis

Abstract: A 66-year-old female with a past medical history of psoriasis and chronic sinusitis presented with left orbital pain, proptosis, ptosis, and blurry vision, concerning for orbital cellulitis. Imaging revealed an enhancing soft tissue mass centered in the left anterior ethmoid cavity with extension into the nasolacrimal duct, with associated osseous erosion and orbital inflammatory changes consistent with ipsilateral orbital cellulitis. Endoscopic surgical resection was performed, and histopathology confirmed inverted papilloma without high-grade dysplasia or carcinoma. While orbital involvement has been described in prior reports, presentation with secondary infectious complications such as orbital cellulitis is rare. This case expands the limited, yet growing, body of literature on the various clinical presentations of orbital inverted papilloma.