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We report the case of a 72\u2010year\u2010old male presenting with progressive unilateral proptosis, upper eyelid swelling, and restricted ocular motility. Imaging showed a well\u2010defined mass infiltrating multiple orbital structures, histopathologically supporting orbital spindle cell carcinoma after ruling out other mimics. After surgical debulking, followed by chemotherapy and radiotherapy, the tumor showed aggressive invasion with local infiltration, bone destruction, and intracranial extension, which ultimately led to the patient\u2032s death. This case underscores detection and management challenges in the primary orbital spindle cell carcinoma. This tumor\u2032s aggressiveness and resistance to traditional treatment approaches reveal the need for further investigation into its etiology and better management techniques.<\/jats:p>","DOI":"10.1155\/crop\/9357403","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:12:02Z","timestamp":1789564322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Refractory Orbital Spindle Cell Carcinoma With Rapid Progression and Intracranial Extension"],"prefix":"10.1155","volume":"2026","author":[{"given":"Elizabeth A.","family":"Bradley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6583-3028","authenticated-orcid":false,"given":"Reza","family":"Nabie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6124-2599","authenticated-orcid":false,"given":"Shadi","family":"Farabi Maleki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-6053(03)00069-3"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-245118"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.1000-9604.2013.08.04"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.59.5.479"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000490060"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-023-03125-7"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.15761\/DOCR.1000268"},{"key":"e_1_2_9_8_2","first-page":"4489","article-title":"Sarcomatoid Carcinoma Involving the Nasal Cavity and Paranasal Sinus: A Rare and Highly Progressive Tumor","volume":"7","author":"Guan M.","year":"2014","journal-title":"International Journal of Clinical and Experimental Pathology"},{"key":"e_1_2_9_9_2","doi-asserted-by":"crossref","first-page":"5263","DOI":"10.1007\/978-3-030-42634-7_66","volume-title":"Albert and Jakobiec\u2032s Principles and Practice of Ophthalmology","author":"Lane K. 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