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October 1996


Arch Otolaryngol Head Neck Surg. 1996;122(10):1130-1133. doi:10.1001/archotol.1996.01890220094016

Pathologic Quiz Case 1  Kim M. Ruska, MD; William H. Westra, MD; The Johns Hopkins Medical Institutions, Baltimore, MdA 48-year-old woman presented with a 2-year history of progressive protusion of the left eye and worsening vision. Her medical history was remarkable for rheumatic fever, chronic headaches, and resection of an acoustic neuroma 13 years earlier, which left her with a mild right facial palsy. Physical examination revealed proptosis, an afferent pupillary defect, and decreased visual acuity (20/50) in the left eye. In addition, the extraocular movements were limited on the left side.Magnetic resonance imaging showed a 3.5-cm mass in the left retro-orbital soft tissues. The mass was located medial and superior to the left orbit and was associated with proptosis (Figure 1). At craniotomy, some areas of the tumor appeared well circumscribed and could be easily separated from the surrounding tissues. Other areas of the tumor, however, appeared