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Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Axial post contrast CT paranasal sinus reveals multiple pockets of nonenhancing areas of hypodensity with likely fluid-fluid levels.

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Axial noncontrast CT paranasal sinus images in bone window reveal a large, expansile, well-circumscribed, corticated left sinonasal mass involving the left ethmoid sinus, nasal cavity and left maxillary sinus. The mass is remodelling the left maxillary sinus medial wall and bulging into the left side of nasopharynx. There are plaque-like areas of high density (180 - 220 HU) within the lesion suggestive of calcification or ossification. The lesion extends into the left orbit via inferior orbital fissure causing left orbital proptosis

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Coronal CT paranasal sinus images in bone window show supero-inferior extent of the lesion (the mass seen extending from roof of the nasal cavity to the maxilla). The mass is remodeling the alveolar process of left maxilla with erosion of medial maxillary sinus wall, medial wall and floor of left orbit with intraorbital extension. The medial wall of right maxillary sinus is also deviated. No erosion of crista galli or floor of anterior cranial fossa noted.

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Axial T2 weighted MRI images through the paranasal sinuses demonstrate multiple fluid-fluid levels.

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Coronal T2 weighted MRI images through the paranasal sinuses demonstrate multiple fluid-fluid levels.

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Axial T1 weighted MRI images through the paranasal sinuses show multiple fluid-fluid levels. Few of these areas are showing T1 hyperintense signal also representing thick secretions or blood-blood levels.

Click 25-year-old male with cemento-ossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis. Post contrast axial T1 fat suppressed MRI images show irregular rim and solid areas of enhancement with associated premaxillary soft tissue thickening and collection.