To describe a case of metastatic lung carcinoma to the cavernous sinus and orbital apex diagnosed by fine-needle aspiration guided by computed tomography. Case report. A 52-year-old man who presented with right-sided ptosis and ophthalmoplegia was found to have an enhancing mass of the right orbital apex and cavernous sinus extending into the temporal fossa on magnetic resonance imaging. Chest computed tomography revealed hilar adenopathy and a lesion of the right lower lobe of the lung. Bronchial washings and transbronchial needle biopsies of the lung were nondiagnostic. Computed tomography-guided fine-needle aspiration of the temporal fossa portion of the mass was performed. Biopsy of the mass showed malignant cells consistent with metastatic non-small cell lung carcinoma. Computed tomography-guided fine-needle aspiration can be useful in the diagnosis and management of some masses involving the cavernous sinus.
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