Introduction: Although ocular adnexal cancers are relatively uncommon, their distinct spreading behavior and the functional significance of the eye and periocular tissues necessitate special diagnostic and therapy considerations. Case presentation: In this case, a 50-year-old male admitted to a rural hospital in Wardha. He was admitted with complaints of small growth over the upper eyelid since 1 year hence he visited to a private hospital and took homeopathic treatment but did not get relief. Then it increased in size of swelling hence he visited to rural hospital in Wardha and was investigated. CECT Orbit (10.05.2022) – There is an e/o heterogeneously enhancing soft tissue density lesion with areas of necrosis within it seen in the left periorbital region. The lesion measures 3.6*4.4*3.8 cm. The lesion is causing erosive destruction of the lateral wall of the left orbit and the anterior part of the left zygomatic arch. Anteriorly the fat plane is lost with preseptal and premaxillary soft tissues, medially involving the extra and intraconal compartment, lateral rectus muscle the fat plane with eyeball is lost with its compression, laterally involving the full thickness of adjacent subcutaneous tissue. A similar small lesion is seen in the subcutaneous plane adjacent to the left zygomatic arch. There are enhancing LNs seen in bilateral submental, submandibular, left preauricular region largest of size 18*10 mm with necrosis within in left submandibular region. There is an e/o heterogeneously enhancing lesion seen in the left parotid region with a necrotic area within it. Previous treatment has taken Surgery (06.06.2022) – Left Orbital exenteration with left MRND and left free ALT flap. He had started radiotherapy and completed 30 fractions Patient was admitted under radiation oncology. Conclusion: Careful visual examination should be a part of cancer patients' long-term follow-up strategy. Timely treatment and management of disease complications can be prevented.
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