Fig. 11.

75-year-old woman with unknown facial filler injections eight months back and left epiphora since one month. Coronal STIR (a) and coronal gadolinium enhanced fat saturated T1 W (b) images show the sites of previous filler injections (short arrows) and an irregular mass in the left lacrimal fossa with extension to nasolacrimal duct (dashed arrows in a and b). The spiculated, enhancing lesion well seen on the axial fat saturated contrast enhanced T1 W image (dashed arrows in c). It shows restricted diffusion on the corresponding ADC map (arrow in d). Furthermore, one would not expect filler injection in this location. Initial histopathology showed evidence of an inflammatory nodule. Repeat biopsy, however, revealed squamous cell carcinoma of the lacrimal sac