Cavernous sinus syndrome as the first presenting sign of metastatic cholangiocarcinoma

Abstract

Cholangiocarcinoma is poorly treatable and highly lethal adenocarcinoma of the hepatobiliary system. The incidence of brain metastases was 0.15%, 0.47% and 1.4% in three large case series. Cavernous sinus syndrome (CSS) refers to any disease involving the cavernous sinus. It is characterized by ophthalmoplegia, proptosis, chemosis, but also trigeminal sensory loss and Horner’s syndrome. We report the case of a 56-year-old Caucasian woman evaluated due to partial Horner syndrome, periorbital and retroorbital unilateral moderate-to-severe headache involving the left frontal and temporal areas of about 2 weeks duration.