Dear students, residents, fellows, staffs, & others
This fascinating CPC case is a 45-year-old man who presented with left (& then bilateral) ear pain & hearing loss for 6 months, left (& then bilateral) eye pain & visual loss for 5 months, left odynophagia & dysphagia for 4 months; in accompanying with abnormal imagings exhibiting infiltrative lesions at nasopharynx & encasing left ICA, & at sphenoid, ethmoid & left cavernous sinuses & orbital apex; multiple lung nodules with & without cavitations; & positive C-ANCA, antIPR3, cryoglobulin, RF, & Coombs' test.
Every one is very much welcome to comment &/or give an answer with explanations