There is a large, intensely enhancing mass lesion with marked osseous remodeling and/or dehiscence, centered within and totally replacing the sphenoid sinus with multicompartment extension. There are several serpiginous flow-voids within the mass reflecting enlarged
feeding vessels. There is lateral extension of the mass lesion with expansion of the left
pterygopalatine fossa and left inferior orbital fissure. There is superior displacement of the left intraorbital optic nerve and left medial rectus muscle.
There is extension into the anterior cranial fossa with marked dehiscence of the planum sphenoidale and sellar floor. There is extension into the left middle cranial and left infratemporal fossa/masticator space.
There is sinonasal extension primarily into the right maxillary sinus with near total opacification. There is left middle ear/mastoid effusion.