Clinical Photo of The Week - Vol3, No2

This case was presented in the recent edition of the otorhinolaryngology news:
A 30-year old male was referred on account of 11 months history of right sided epistaxis, 3 months history of twisting of the face to the left side, and drooping of upper right eyelid. He had always done clerical jobs. Examination revealed right ptosis, right complete lower motor neuron facial nerve palsy, right soft palatal paralysis and the tongue sign demonstrated in this picture. EUA postnasal space revealed scanty soft tissue mass admixed with old blood clots. You may want to view his MRI of sinuses / brain findings for more detail.
Diagnosis: Parapharyngeal Tumour involving the skull bas with multiple cranial neuropathy