A 25-year-old shepherdess from the Turkana district of Kenya presented to a Nairobi hospital with a 1-year history of painless, progressive proptosis of the right eye. She denied diplopia as well as all sinus symptoms, including facial pain, headache, and nasal obstruction. Nasal endoscopy revealed a smooth mass that was bulging into the middle meatus. It was soft and nontender to palpation. The right eye was markedly proptotic, but the findings of the rest of the physical examination were normal, including her vision and extraocular muscle movements. She had no other medical or surgical history.
Groves MW, Müller S, Gathere S, Gachii A, Johns MM. Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2009;135(10):1056-1060. doi:10.1001/archoto.2009.124-a