A 27-year-old man presented with a 2-month history of retro-orbital pain and a 2-week history of progressive ptosis and diplopia. Neurological examination revealed left partial third, fourth and sixth cranial nerve paresis. Imaging revealed a large middle fossa lesion with heterogeneous signal intensity. During surgery, the tumor was found to be entirely within the confines of the dural layers of the lateral wall of the cavernous sinus. Histological analysis revealed that the tumor was a mature teratoma. The case is discussed and the literature on this rare location of teratoma is reviewed.
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