Inverted papillomas are benign but invasive tumors with malignant potential characterized by a high recurrence rate. Although most cases arise from the nasal wall and paranasal sinuses, inverted papillomas originating from the nasolacrimal system have been rarely reported. We describe a rare case of an inverted papilloma in the left nasal cavity, which originated from the lacrimal sac in a 40-year-old female who had a medical history of endoscopic dacryocystorhinostomy at the department of ophthalmology. At first, it was believed to be an inverted papilloma simply occurring in the nasal cavity, but after several recurrences, it was found to originate from the lacrimal sac. All intranasal lesions and the involved lacrimal sac were removed through cooperative surgery between department of otolaryngology and ophthalmology. This case illustrates the importance of including nasolacrimal system in differentiating the origin of inverted papilloma.

The Good's syndrome is a rare immunodeficiency disease characterized by thymoma and hypogammaglobulinemia. The most common cause of infection in patients with Good's syndrome is the recurrent sinopulmonary infection. One may assume that there could be an unknown immunocompromising condition such as Good's syndrome in cases of chronic rhinosinusitis refractory to treatment. We experienced a patient with Good's syndrome, presenting with chronic rhinosinusitis refractory to treatment. We report this case with a brief review of the literature.