PATHOLOGIC QUIZ CASE
Phillip F. Anthony, MD, Houston
The patient was a 38-year-old man who, during his first examination, gave a three-month history of protrusion of his left eye and a two-week history of left medial inferior orbital rim discomfort without diplopia or loss of visual acuity. A left frontoethmoid mass was noted and piecemeal resection with fat obliteration was performed. Five years later, he returned with a one-year history of gradually progressive left proptosis. Examination disclosed lateral inferior globe displacement and a mass in the superior medial orbital rim that was hard, nontender, and immobile (Fig 1). Facial x-ray films showed a bony left frontoethmoid mass, with extension posteriorly along the left superior and medial orbital mass to within 1 to 2 mm of the orbital foramen (Fig 2 and 3). Digital axial tomograms showed a bony mass along the medial orbital wall without involvement of the optic foramen