A 51-year-old man noticed "bulging" of his eyes, most prominent on the left. Two months later, he developed diplopia with lateral gaze in either direction. MRI demonstrated bilateral retro-ocular intraconal masses causing exophthalmos (L > R), abnormal enhancement of the cavernous sinuses, as well as dural enhancement adjacent to the sagittal sinus, most evident at the torcula. Osseous changes involving the maxilla and clivus were noted, likely representing osteosclerosis. The optic nerves were normal.
Diva Salomao, M.D.
Consultant, Anatomic Pathology
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine