Fig. 2

Postoperative and follow-up MRI brain and orbits after initial and second surgical debulkings. a Postoperative T1-weighted post-contrast MRI brain and orbits obtained after initial surgical debulking demonstrating significant resection at the level of the optic nerve with residual enhancing mass in the infraorbital region, left cheek, and maxillary sinus. There is residual circumferential enhancement around the optic nerve at the orbital apex. A small postoperative fluid collection along the lateral and inferior left orbit is also observed. b Follow-up T1-weighted post-contrast MRI obtained approximately 2 months after initial surgical debulking showing increased lobular enhancing soft tissue mass protruding through the left orbital floor into the left maxillary sinus. Increased enhancement in the left retromaxillary fat and along the left maxillary alveolar ridge are consistent with progressive disease. c Follow-up MRI obtained approximately 1 month after second surgical debulking demonstrating interval resection of the premaxillary and infraorbital soft tissue enhancement without evidence of disease progression