Presentation
Right orbital mass with numbness of the the right cheek and diplopia on upward gaze.
Patient Data
There is thick enhancement along the entire right orbital floor that extends laterally into the lateral right orbital fat almost reaching the lacrimal gland. There is enhancement along the posterior lateral wall the right maxillary sinus concerning for retromaxillary spread of a tumor. There is intense, irregular enhancement within the right pterygopalatine fossa and linear enhancement which extends posteriorly possibly within the vidian canal.
Case Discussion
This is an adenoid cystic carcinoma.
The patient underwent a combined open and endoscopic approach partial resection and orbital enucleation. Histopathology was notable for a moderately differentiated adenoid cystic carcinoma with a largely cribriform growth pattern. There was involvement of both bone and nerve (maxillary division of the trigeminal nerve).
She received post-operative radiotherapy and has had multiple surgical reconstructions of her orbit.
Co-author:
Rushali Kothari