Contrast-enhanced computed tomography (CECT) of the base of skull and nasopharynx showed contrast-enhancing heterogeneous mass lesion involving the left nasopharynx, sphenoid sinus, and base of skull [Figure 3], without any significant cervical lymphadenopathy.
Imaging, which included CT brain, MRI brain, and CT sinuses, demonstrated hyperdense soft-tissue opacification of the right frontal, sphenoid sinuses, and ethmoidal air cells with corresponding decreased T2 signal and osseous erosive changes involving medial orbital wall with soft tissue extending to the orbital apex.
Further-more, as knowledge about the anatomy of the sinuses has improved, other ancillary surgeries such as endoscopic lacrimal surgery, orbital decompression, optic nerve decompression, approaches for the sphenoid sinus for cysts or mass, and approaches for pituitary fossa for inflammatory pathologies or tumour, have become easier.
The tumor was found to be invading the infratemporal fossa, extending anteriorly up to the temporomandibular joint and inferiorly up to the greater wing of the sphenoid bone.
Magnetic resonance imaging [Figure 1] showed a 3.5 x 3.4 x 6.7 cm well-defined hyperintense expansile soft tissue lesion arising from the nasopharynx, invading sphenoid and clivus.
For tumours infiltrating into infratemporal fossa, sphenoid sinus, base of pterygoid, cavernous sinus, foramen lacerum, anterior and middle cranial fossa [1], subtotal tumour excision predisposes to recurrence.
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