To describe a case of metastatic lung carcinoma to the cavernous sinus and orb ital apex diagnosed by fine needle aspiration guided by computed tomography. Ca se report. A 52 year old man who presented with right sided ptosis and ophtha lmoplegia was found to have an enhancing mass of the right orbital apex and cave rnous sinus extending into the temporal fossa on magnetic resonance imaging. Che st computed tomography revealed hilar adenopathy and a lesion of the right lower lobe of the lung. Bronchial washings and transbronchial needle biopsies of the lung were nondiagnostic. Computed tomography guided fineneedle aspiration of th e temporal fossa portion of the mass was performed. Biopsy of the mass showed ma lignant cells consistent with metastatic non small cell lung carcinoma. Compute d tomography guided fine needle aspiration can be useful in the diagnosis and management of some masses involving the cavernous sinus. To describe a case of metastatic lung carcinoma to the cavernous sinus and orb ital apex diagnosed by fine needle aspiration guided by computed tomography. Ca se report. A 52 year old man who presented with right sided ptosis and ophtha lmoplegia was found to have an enhancing mass of the right orbital apex and cave rnous sinus extends into the temporal fossa on magnetic resonance imaging. Che st computed tomography revealed hilar adenopathy and a lesion of the right lower lobe of the lung. Bronchial washings and transbronchial needle biopsies of the lung were nondiagnostic Computed tomography guided fineneedle aspiration of th e temporal fossa portion of the mass was performed. Biopsy of the mass showed ma lignant cells consistent with metastatic non small cell lung carcinoma. Compute tomography guided fine needle aspiration can be useful in the diagnosis and management of some masses involving the cavernous sinus.