A forty year old female presented with a swelling above the medial canthal tendon, later diagnosed as a mucus secreting adenocarcinoma. This rare carcinoma arose within an inverted papilloma lined by ciliated respiratory type columnar epithelium incorporating numerous goblet cells. We were only able to find two such cases reported in the literature. The history, clinical features, histological characteristics and management are discussed. The case highlights the importance of early recognition of these tumours along with need for aggressive management.