Management strategy for malignant tumor of the nasal sinus invading the eye General: Patient, female, 9 years old Complaint: “Left-sided nasal blockage with intermittent headache for 6 months, protruding left eyeball with progressive aggravation for 20 days”. Treatment history: In January 2012, a left-sided nasal blockage with intermittent headache started 5 months before the “functional sinus opening” was performed in an outside hospital. In March 2012, “nasal endoscopic sinus opening” was performed under general anesthesia in a hospital of a medical university. Postoperative pathological diagnosis: polypoid hyperplasia of nasal mucosa with active lymphocyte proliferation and partial inflammatory necrosis, and immunohistochemistry was recommended to confirm the diagnosis at a higher hospital. After surgery, the child developed a protruding left eyeball, which was progressively worsening. In April 2012, he was admitted to the Department of Otolaryngology, Head and Neck Surgery, Department of Oncology and Department of Pediatrics of Beijing Tongren Hospital. On examination, the left eyeball was obviously protruding, the eyelid could not be opened, the conjunctiva was not congested, the sclera was not yellowish, the movement of the left eyeball was limited in all directions, there was no visual acuity, the pupil diameter was about 4 mm, and the reflex to light was absent. The right eye had no restriction of movement and normal gross visual acuity. The left maxillary sinus and septal sinus were positive for pressure pain, and the lymph nodes in the neck were obviously enlarged bilaterally, with the largest diameter of about 3 cm on the left side and hard texture. Pathological diagnosis: Pathological diagnosis of Beijing Tongren Hospital: (left maxillary sinus and sieve sinus) highly malignant tumor, HE and immunohistochemistry results support the original nerve origin tumor, combined with the clinical location, consider the possibility of olfactory neuroblastoma (grade III-IV), with extensive hemorrhage and necrosis, and a large number of bovine fungal filaments seen on the mucosal surface to destroy the mucosa. Immunohistochemistry: CK-, Vimentin +, EMA -, CD56+, CD99-/+, ki-67index 70%. NSE foci +, LcA-, S100-, Cga-, syn-. Admission diagnosis: Olfactory neuroblastoma stage D chemotherapy; post functional opening of the sinuses. Treatment history: Carboplatin, paclitaxel and vincristine were given in April 2012 for a total of four courses of treatment. Two nasal biopsies were performed in August 2012, and no tumor cells were seen on examination. Radiotherapy was started in September 2012.