Left frontal orbital tumor with skull base extension, 3 month follow-up There is been evolution of postoperative findings related to left craniotomy and orbitotomy with reconstruction and obliteration of the left frontal sinus and reconstruction of orbital rim. There has been resolution of the previously seen postoperative fluid collection in the superior left orbit with mild soft tissue thickening compatible with postsurgical change. There is mild increase in dural thickening along the left frontotemporal convexity and above the superior orbital wall consistent with postoperative change. Focal enhancement involving the posterior aspect of the left orbital roof is noted (coronal postgad image 8/17 series 20) and may be related to postoperative change. Otherwise no discrete intraorbital or intracranial mass or nodular enhancement is appreciated to suggest tumor.Again seen is medial bowing of the lateral wall of the left orbit associated with a middle cranial fossa arachnoid cyst that measures approximately 2 x 3 cm and unchanged. The bilateral optic nerves appear to be intact. There is mild left cerebral convexity dural postoperative enhancement. There is mild edema in the left orbitofrontal gyri. The ventricles are unchanged in size and configuration, with a left choroid fissure cyst. There is no midline shift or herniation. There is moderate right maxillary sinus mucosal thickening and a left sphenoid sinus retention cyst. There is minimal fluid signal in the right mastoid air cells.
1. Evolution of postoperative findings related to left superior orbital wall reconstruction and left frontal sinus decompression. There has been resolution of previously seen fluid collection in the superior left orbit with residual thickening and enhancement compatible with granulation tissue. Focal enhancement of the posterior aspect of the left orbital roof is noted (coronal postgad image 8/17 series 20) and may be related to postoperative change. No discrete intraorbital or intracranial mass is otherwise appreciated to suggest tumor. CT of the orbits may be helpful to assess for residual osseous component of tumor.2. Unchanged left middle cranial fossa arachnoid cyst with associated medial bowing of the left lateral orbital wall.