title: Bilateral profound hearing loss due to meningeal carcinomatosis.
abstract: Meningeal carcinomatosis (MC) is an uncommon form of metastasis of solid tumors. Hearing loss as the presenting symptom of MC is very uncommon. A patient with an esophageal signet ring cell carcinoma 3 years previously presented with sudden onset of profound hearing loss affecting both ears. He had no evidence of local tumor recurrence. Brain magnetic resonance imaging (MRI) showed swelling and increased signal intensity on T2 weighted images of both acoustic nerves and the right trigeminal nerve. After gadolinium administration, enhancement of both acoustic and trigeminal nerves was seen. He later developed unsteadiness and head-movement-dependent oscillopsia due to vestibular areflexia and diplopia. At that time MRI showed leptomeningeal enhancement. MC was diagnosed, although cerebrospinal fluid cytology could not confirm that diagnosis. The patient died 16 weeks after the onset of deafness. In patients with progressive unilateral and bilateral hearing loss, meningeal carcinomatosis should be considered, especially if there is a history of previous malignancy.
authors.affiliation: Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Michiel
authors.initials: M
authors.lastname: Wagemakers
authors.forename: Wim
authors.initials: W
authors.lastname: Verhagen
authors.forename: Bas van de
authors.initials: Bv
authors.lastname: Borne
authors.forename: Dick
authors.initials: D
authors.lastname: Venderink
authors.forename: Carla
authors.initials: C
authors.lastname: Wauters
authors.forename: Luc
authors.initials: L
authors.lastname: Strobbe
mesh_terms: D002277:Carcinoma / Q000150:complications* / Q000556:secondary; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology; D003056:Cochlear Nerve / Q000473:pathology; D004938:Esophageal Neoplasms / Q000473:pathology; D017809:Fatal Outcome; D006312:Hearing Loss, Bilateral / Q000209:etiology*; D006320:Hearing Tests; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000556:secondary; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology; D014276:Trigeminal Nerve / Q000473:pathology