A 64 year old man was referred to the Department of Ophthalmology (Southern General Hospital) with 4 month history of painless swelling of the left side of the left orbit. There was no diplopia. His general health appeared reasonably good. Examination showed fullness in the region of the lacrimal gland associated with ecchymosis (fig 1). Visual acuity was 20/20 in each eye. Direct coronal computerised tomography scan of the orbits (fig 2) showed the presence of an extensive ill defined mass lying in the anterior third of the orbit and displacing the globe medially and slightly downwards. The superior and lateral rectus muscles could not be seen separate from the mass anteriorly although they were defined posteriorly. There was no evidence of perineural spread. The radiologist concluded that the appearance is consistent …