PMC7787826_01
(a) Complete left ophthalmoplegia and left upper-eyelid ptosis. (b) Actinic keratosis of the left cheek. (c) Facial and orbital MRI: sagittal view: infiltrating lesion extending through the left infraorbital canal orbital apex and the left cavernous sinus with perineural infiltration. (d) Facial and orbital MRI: coronal view: infiltrating left orbital process started from the left cheek with a large amount of necrosis.
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fig1
Clinical examination revealed complete left III, IV, and VI nerve palsy (Figure 1(b)) and trigeminal hypoesthesia with left face numbness. A second homogenous infiltrating process in the deep facial massif was described, invading the left masticator space, the pterygopalatine fossa, the temporal anterior left meninx, the orbital apex, and the left cavernous sinus with perineural infiltration (Figures 1(c) and 1(d)).