Orbital apex squamous cell carcinoma

A middle-aged lady was referred to the Otolaryngology department for consideration of an endoscopic biopsy of a mass located in the right orbital apex. She had initially presented to the eye clinic with complaints of right proptosis and worsening vision. Upon examination, her right eye showed no perception of light, an amaurotic right pupil, and limited extraocular movement in all directions of gaze. Hertel's ophthalmometer revealed proptosis, and there was a loss of corneal sensation. Magnetic resonance imaging (MRI) of the orbits revealed an enhancing mass in the right orbital apex, extending into the cavernous sinus. She subsequently underwent an endoscopic trans-sphenoidal biopsy of the lesion. Histopathological analysis confirmed the pre- sence of squamous cell carcinoma (SCC). Further systemic evaluation did not reveal any other primary site or metastasis. Conside- ring the unresectable nature of the tumor and her poor candidacy for chemotherapy and radiotherapy, the patient was managed with best supportive care.