title: Pancreatic adenocarcinoma presenting with sudden onset bilateral deafness secondary to metastatic leptomeningeal infiltration.
abstract: Deafness is a very common problem in older persons. We present a case of metastatic adenocarcinoma of the pancreas with deafness being the patient's only reason for seeking medical attention. The patient had bilateral vestibulocochlear nerve palsies with associated lower motor neurone facial nerve palsies and a bulbar palsy. Magnetic resonance imaging of his brain was unremarkable. It was only on post-mortem histology that tumour infiltrating the leptomeninges was demonstrated. Leptomeningeal metastases are rarely associated with adenocarcinoma of the pancreas. A review of the literature reveals only two other case reports of mestatic pancreatic carcinoma presenting with deafness but both had demonstrable temporal bone lesions on MRI as opposed to the meninges.
authors: Elderly Medicine, Chelsea and Westminster Hospital, London, UK. samuelblows@doctors.org.uk
authors: Samuel Joseph
authors: SJ
authors: Blows
authors: Richard
authors: R
authors: Morgan
authors: Umeet
authors: U
authors: Dhariwal
authors: Gemma
authors: G
authors: Petts
authors: Frederico
authors: F
authors: Roncaroli
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000556:secondary*; D000368:Aged; D001344:Autopsy; D003638:Deafness / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary*; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013702:Temporal Lobe / Q000473:pathology