title: Vertigo and hearing disturbance as the first sign of a glioblastoma (World Health Organization grade IV).
abstract: OBJECTIVE
  To describe vertigo and hearing disturbance as a first sign of glioblastoma.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Ear, Nose, and Throat Department of the University of Regensberg, Germany. Primary Care Center.
  
  
  METHODS
  A patient with a left temporal glioblastoma.
  
  
  RESULTS
  A 67-year-old man presented with a 2-month history of vertigo and hearing disturbance. Radiological imaging revealed a left temporal tumor with dural inflation and erosion of the petrous bone and superior semicircular duct. The surgery involved total resection of the tumor and resurfacing of the gap in the superior canal. The histopathological examination revealed World Health Trade Organization IV glioblastoma. Postoperatively, the debilitating symptoms were relieved and the patient received radiation therapy. Tumor progression indicated a recraniotomy and a mastoidectomy. The tumor was only partially resected, and required chemotherapy. It subsequently developed otoliquorrhea and required a remastoidectomy. Histopathology of a pathological fracture of the X thoracic vertebra revealed a metastasis of the known glioblastoma. The patient died from respiratory distress syndrome.
  
  
  CONCLUSIONS
  To the best of our knowledge, we are presenting the first case with transdural infiltration of bony structures by a glioblastoma at the moment of diagnosis. The transdural spread could be via the sinus petrosus and along the nervous petrosus major in the petrosal bone. Superior canal dehiscence syndrome should be considered in the differential diagnosis of vertigo and hearing disturbance. Two different processes for the etiology of the superior canal dehiscence syndrome are discussed previously in the literature; however, we present a new entity with a tumor-cause dehiscence of the bone overlying the superior canal.
authors.affiliation: Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany. katharina.licht@klinik.uni-regensburg.de
authors.forename: Anna-K
authors.initials: AK
authors.lastname: Licht
authors.forename: Frank
authors.initials: F
authors.lastname: Schulmeyer
authors.forename: Max
authors.initials: M
authors.lastname: Allert
authors.forename: Paul
authors.initials: P
authors.lastname: Held
authors.forename: Matthias
authors.initials: M
authors.lastname: Woenckhaus
authors.forename: Jürgen
authors.initials: J
authors.lastname: Strutz
mesh_terms: D000368:Aged; D001301:Audiometry, Pure-Tone; D004428:Ear Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D017809:Fatal Outcome; D005909:Glioblastoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures; D012665:Semicircular Canals / Q000473:pathology; D014012:Tinnitus / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000209:etiology* / Q000503:physiopathology; D014944:World Health Organization