A case of right paranasal sinus squamous cell carcinoma. Staging (using the system for tumors of the maxillary sinus): 

• T4a: tumor invasion of the orbit and infratemporal fossa WITHOUT extension into the orbital apex, dura, brain, middle cranial fossa, nasopharynx, clivus or cranial nerves other than V2.
• N0: no nodal metastasis.

The patient went on to have extensive craniofacial resection which revealed a poorly differentiated basaloid SCC involving maxillary, sphenoid and ethmoid sinuses. Bony, perineural and lymphovascular invasion was identified.

Case submitted by Dr Smita Deb and A/Prof Pramit Phal.