A 40-year-old male presented with 2 weeks of left facial pain, nasal congestion, dysphonia, and epistaxis along with left-sided epiphora. CT showed a large infiltrative mass centered in the left maxillary sinus with extension into the left orbit, bilateral paranasal sinuses, nasal cavity, and bilateral enlarged cervical lymph nodes. Biopsy results confirmed adult alveolar rhabdomyosarcoma (RMS). Systemic workup confirmed bilateral cervical lymph node metastasis. Currently the patient is undergoing chemotherapy. We describe a rare case of adult paranasal sinus RMS with orbital invasion.

Endometrial implants have long been noticed to decidualize during pregnancies. They have been reported in a variety of locations in the pelvis and abdomen. These lesions are usually noted incidentally with no negative sequelae. This is not always the case and we present a case of massive hemorrhage from decidualized endometriotic lesions during a cesarean section.