Purpose: Transitional cell carcinomas of the lacrimal sac are rare with less than 55 cases reported in the literature. These tumors typically present with a medial canthal mass and epiphora. Observations: Here we describe a 63-year-old male who presented originally with complaints of dry eye and chronic epiphora. https://www.roneverhart.com/Phenix-First-Due-EMS-Responder-Helmet/