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Lacrimal sac tumors are relatively rare and more often malignant than benign. Primary epithelial origin tumors are the most comon, folowed by those of mesenchymal origin. The clinical manifestations of lacrimal sac tumors include unilateral epiphora, usualy need to confirm the lacrimal sac malignancy. The lacrimal sac cancer can be managed by complete surgical excision and postoperative radiotherapy. We reported a case of a priamry squamous cell carcinoma of lacrimal sac with the review of literatures. The 43-year-old patient underwent wide excision of the lacrimal sac mas with medial maxillectomy and ethmoidectomy via lateral rhinotomy approach. Postoperative radiation therapy was done. (Korean J Otolaryngol 2002 ;45 :110-3)