Rhabdomyosarcoma of the paranasal sinuses in an adult

A 48-year-old, right-handed woman presented with a 4-month history of tearing in the left eye. This was associated with insidious onset of frontal and left periorbital discomfort. The patient also experienced occasional epistaxis and diplopia. Her medical history was significant only for hypertension. Physical examination identified bilateral anosmia and left proptosis. The latter was associated with restriction of upward and lateral gaze. The remainder of the physical examination and the hematological workup were unremarkable. A computed tomography (CT) examination [Figure 1) demonstrated a bulky, destructive soft-tissue mass within the left sinonasal cavity. The epicenter was