BACKGROUND. Antrochoanal polyps (ACP) were originally reported by Gustav Killian in 1906. Antrochoanal polyps (ACPs) are benign polypoid lesions that begin in the maxillary antrum and extend into the choana. Although there have been recorded occurrences of bilateral ACPs in the literature, ACPs are mostly unilateral. They typically have an impact on youth and youngsters. MATERIAL AND METHODS. In a trial of 15 cases treated and admitted to our ENT Pediatric Department at the Emergency County Hospital Timisoara over the previous four years, the pathology, differential diagnosis, treatment, complications, etiopathogenesis, clinical features, positive and differential diagnosis, preoperative evaluation, pathology, and treatment of ACPs were reviewed in this study. RESULTS. The patients age group comprised five females (33.33%) and ten boys (66.67%), ranging in age from 7 to 16 years. The most common presenting symptoms were unilateral nasal obstruction (100%), purulent rhinorrhea (66.67%), olfactory impairment (53.33%), and mouth breathing (46.67%). A nasal endoscopy and a craniofacial CT scan were the gold standards for diagnosing ACP. The chosen course of treatment for all pediatric patients included in the study was surgery: 12 patients (80%) underwent transnasal endoscopic polypectomy, and 3 patients (20%) underwent both transnasal polypectomy and transcanine fossa approach. The success rate of the combined endoscopic and transcanine fossa approach was 100%, whereas the transnasal endoscopic surgery (polypectomy) had an 80% success rate. CONCLUSION. Polypectomy combined with a transcanine fossa approach technique and transnasal polypectomy is the optimal course of treatment.

Background and Objectives: Lacrimal sac/nasolacrimal duct (LS/NLD) tumors may present as primary acquired nasolacrimal duct obstruction (PANDO), raising debate over routine versus selective dacryocystorhinostomy (DCR) biopsy. We systematically reviewed (i) biopsy yields in routine versus selective strategies, (ii) clinical/imaging red flags for neoplasia, and (iii) outcomes of malignant LS/NLD tumors. Materials and Methods: Following a preregistered PRISMA 2020-compliant protocol, we searched PubMed/MEDLINE, Web of Science, and Scopus (1970–2025) for adult cohorts reporting histopathology, imaging, or oncologic outcomes in PANDO/DCR or LS/NLD tumors. Eligible designs included comparative, cohort, cross-sectional, and diagnostic accuracy studies with histology as a reference. Results: Across 16 cohorts, routine DCR series reported “any specific pathology” in 0–7.91% of specimens and malignant yields generally ≤0.73%. In Anderson, 7.91% of 316 patients had significant pathology and 4.43% neoplasia, with 2.53% unsuspected pre-/intra-operatively. Selective biopsy or tumor-enriched cohorts showed higher malignant burdens; pooled modern data yielded ~72.8% squamous cell carcinoma and ~21.4% lymphoma among malignancies. Imaging red flags included bone erosion (50% malignant vs. 11% benign) and infiltrative patterns (63% vs. 0%), while sac masses were present in 88% of tumors in one recent series. In LSSCC-only cohorts, contemporary multimodal therapy achieved 5-year overall survival of 87.6% and progression-free survival of 76.3%. Conclusions: Malignancy is rare in unselected PANDO but clinically significant when present. A tiered strategy combining bedside red flags, targeted CT/MRI, and selective biopsy appears to balance oncologic safety with resource stewardship and supports histology-directed epithelial versus lymphoma care pathways.