Photographs showing an entire orbitocranial-orbitomaxillary complex after en bloc resection!
This 30-year-old man had a several-month history of nasal congestion, as well as right airway obstruction treated using over-the-counter nose sprays and allergy medications. Subsequently, he began to develop right-sided orbital pain and headache. He underwent endoscopy of the sinus, and an intranasal mass was demonstrated.
The sinonasal endoscopy demonstrated a large friable granular mass filling the posterior and superior right nasal cavity. A biopsy sample was obtained, and examination revealed basaloid-squamous cell carcinoma. A CT study of the sinuses revealed a soft-tissue mass and erosion of the medial wall of the right orbit and cribriform plate. An MR imaging study suggested orbital and cranial invasion.
It was decided to surgical excise the tumor and the surgical defect required a free-flap reconstruction.