Gastroenterology clinical image challenge: A 56-year-old Native American man with a history of hepatitis C infection presented with worsening eye pain, double vision, rapidly progressive loss of visual acuity and exophthalmos with ophthalmoplegia in his right eye. Physical examination findings were suggestive of liver cirrhosis. Cross-sectional imaging of the head and neck showed large extra-axial mass lesion involving the sphenoid wing of the right orbit, anterior cranial fossa, middle cranial fossa, sinus and temporal fossa (Figure). Thyroid function tests were within normal limits.
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