Gradenigo syndrome and primitive sphenoid sinus cancer

Abstract First described in 1907, Gradenigo’s syndrome associates the following triad: acute otitis media as a causative infection of petrous apicitis, ipsilateral abducens nerve palsy and trigeminal neuralgia. This entity is becoming rare because of the wide use of antibiotics. The above definition can be extended as the fifth and sixth cranial nerves are intimately related near the apex of the petrous bone. Thus, any adjacent process may cause petrositis and palsies of these nerves. Paranasal sinus adenocarcinomas are common. But primitive sphenoid bone localization is exceptional and manifest usually with a deep retro orbital headache. 1 Gardenigo’s syndrome is a rare revelation mode of sphenoid tumors. We report the case of a 55-years old female with a history of Budd Chiari syndrome, who presented with a typical Gradenigo’s Syndrome. The imaging showed an invasive process of sphenoid sinus. trans-sphenoidal biopsy concluded to adenocarcinoma. As the patient was inoperable, palliative radiotherapy was indicated.