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This is a 79 year old man with no past medical history who presented to the hospital with a large fungating right facial mass (Figure 1). He reports first noticing a small growth at the right eyebrow over a year ago. Over time, he had become increasingly self conscious of the mass and was isolating himself at home, refusing to go out or seek medical attention. On MRI, the mass extended deep into the right orbit with marked destruction of the right globe, the medial orbital wall, ethmoid, frontal and maxillary sinuses (Figure 2). Biopsy demonstrated invasive squamous cell carcinoma.