Biopsy proven case of granulomatosis with polyangiitis that had been treated with steroid treatment.

The differential diagnoses for orbital masses included a malignant orbital tumor, immunoglobulin G4-related autoimmune disease and an inflammatory pseudotumor.

As with other granulomatous diseases, orbital disease may appear hypointense on T2 MRI.

Complications of orbital Wegener's granulomatosis include optic nerve compression with subsequent atrophy and visual loss.

The patient had "Cushingoid facies" with excessive fat secondary to long-term steroid treatment.