Clinically: 60 y o male with right side painful eye movement, ptosis.
MRI Brain with MR Angiography was normal.
No obvious osseous destruction of CT at orbital apex.
Minimal adjacent sphenoid sinus mucosal thickening.
Inflammatory Pseudo tumor ( most likely)
Sinus disease, fungal.
REPORT OF HISTOPATHOLOGICAL EXAMINATION
Specimen : Right orbital mass.
Gross Appearance : The specimen consists of dull grey soft to firm pieces together measuring 0.3X0.3X0.3 cm. The entire specimen is submitted for processing.
Microscopy : The section shows striated muscle and fibrofatty tissue along with a couple of pieces of (undecalcified) bone. The fibrofatty tissue shows minimal lymphocytic infiltration. The muscle shows considerable degenerative changes however, and consists of fragmented fibers, sarcolemmal nuclear proliferation with mild fibrosis and lymphocytic infiltration. There are no granulomas seen. Deeper sections show similar appearance.
Final Diagnosis : Chronic inflammation with degenerative changes in muscle ? inflammatory pseudotumor.