title: [A rare case of metastatic meningitis with unknown primary focus and atypical symptoms].
abstract: We have presented the diagnostic difficulties in the case of woman aged 59 who was admitted to the clinic with the suspicion of neurinoma of acoustic nerve. The patient was admitted to hospital with peripheral facial nerve paresis on the left side together with sudden surdity and peripheral vestibular impairment. Surdity of the other side occurred after two months. In terminal phase of the disease there was aseptic meningitis. Posthumous diagnosis was made on the basis of neuropathological examination of the brain. It was carcinomatous meningitis. But there was no primary focus found during autopsy. It is important to stress that CT and MRI was completely useless in this case. However pathological brain stem response together with lack of stapedial muscle reflex were much ahead of surdity and other central symptoms. We found only one case of carcinomatous meningitis with unknown primary focus in the literature. The course of the disease is very insidious and in every suspicious cases one should be aware of cancer of unknown primary site.
authors.affiliation: Katedra i Klinika Otolaryngologii AM we Wrocławiu.
authors.forename: L
authors.initials: L
authors.lastname: Pośpiech
authors.forename: K
authors.initials: K
authors.lastname: Orendorz-Fraczkowska
authors.forename: W
authors.initials: W
authors.lastname: Gawron
mesh_terms: D002277:Carcinoma / Q000150:complications / Q000175:diagnosis*; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D003639:Hearing Loss, Sudden / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis*; D008582:Meningitis, Aseptic / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed