Figure 1

Magnetic resonance images demonstrate the initial appearance and response to glucocorticoid mono-therapy. Top row - Imaging of the head and face revealed abnormal thickening of temporalis. Asymmetry and loss of normal facial planes were seen with infiltrates noted in the left infra temporal fossa. Inflammatory changes are also seen in the ethmoid sinus , left maxillary sinus with muco-periosteal thickening and with non-uniform thickening and sclerosis of sinus wall with erosion postero-laterally. Extension of tumour was noted in the left orbit antero-laterally with lacrimal gland involvement. Bottom row- Imaging demonstrates the initial significant response to steroid monotherapy which prompted rapid tailing off.