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Although exenteration and partial maxillectomy were suggested after pathological result showed a carcinoma of lacrimal sac, patient did not want these extensive surgery immediately. On patient request to reserve the eyeball function, navigation-assisted transnasal endoscopic excision is a safe and efficient method for the preliminary surgery. This case of orbital tumor excision using endoscope and IGS navigation system is the first case by Taiwan ophthalmologists.We report here a rare case of Bardet-Biedl syndrome (BBS). A 7-year-old bo