Fig. 1. A 59-year-old woman presented with a 6-month history of left infraorbital pain and dysesthesia. She was found to have maxillary antral squamous cell carcinoma and was treated with radiotherapy. Ten months after radiotherapy, severe left ocular and orbital pain associated with tearing and blurred vision developed. On examination, vision was 20/40 with a fixed, miotic pupil. A firm mass in the floor of the anterior orbit displaced the globe superiorly 5 mm and anteriorly 2 mm. Inferior chemosis, moderate restriction of upgaze, and an intraocular pressure of 30 mmHg (increasing to 40 mmHg on upgaze) were noted. Despite maxillectomy, orbital exenteration, and orbital radiotherapy, the patient had local recurrence and diffuse metastatic disease, and she died 10 months after orbital presentation.