Male, 70 years old, with ptosis and decreased depth perception. Patient status post resection of a left maxillary sinus solitary fibrous tumor with orbital extension. Findings are demonstrated compatible with prior surgeries including endoscopic surgery of the left maxillary sinus and evidence of prior left orbital surgery. A defect is seen within the anterior wall of the left maxillary sinus which may reflect prior surgery as well.A lobular, mildly but homogeneously enhancing tumor is evident occupying the inferior and medial portions of the left orbit. In the axial plane, the major component of this lesion measures 35 x 31 mm, and in the craniocaudal dimension, the lesion measures up to 30 mm. As there does not appear to be an immediate postoperative examination subsequent to the patient's 10-2015 resection, it is unclear how much of this tumor represents residual disease and how much represents interval growth. The tumor on today's examination is, however, smaller than that seen on the preoperative examination of 9/10/2015.The lesion displaces the orbital contents superiorly. The optic nerve is stretched along the superior surface of the tumor, but the tumor does not appear to encase the nerve. The inferior rectus muscle is not well seen, and at some points, there is difficulty in distinguishing the medial and lateral recti muscles from the tumor which could indicate invasion. The left globe is proptotic. Tumor appears to extend medially into the left ethmoid air cells, as well as laterally and inferiorly, through a deficiency of the maxilla, into the premaxillary and retromaxillary spaces. The pterygopalatine fossa does not appear to be invaded.
A large tumor is evident occupying the inferior aspect of the left orbit with extension medially into the ethmoid region, and inferolaterally into the premaxillary and retromaxillary spaces. On comparison with the prior preoperative examination, the lesion is smaller. Given that a surgical resection was performed in the interval, it is unclear to what extent this lesion represents residual versus growing tumor.