title: Hearing loss as an unusual consequence of metastatic gastric adenocarcinoma.
abstract: A sixty-one year old man was referred with a history of progressive dysphagia, vomiting and weight loss with some back pain. Upper gastrointestinal endoscopy and biopsies revealed a gastro-oesophageal junction adenocarcinoma. Despite the absence of metastatic disease on computed tomography, positron emission tomography demonstrated multiple vertebral and sternal deposits. He was reviewed in an ENT clinic with a sudden onset of hearing loss accompanied by dizziness, but no focal neurology. Magnetic resonance imaging identified bilateral 2cm lesions at the internal auditory meatus, consistent with a diagnosis of bilateral acoustic neuromas. The patient subsequently died of carcinomatosis and, because of the potential familial significance of bilateral acoustic neuromas, a limited post-mortem examination was carried out. Unexpectedly, this revealed bilateral adenocarcinoma metastases infiltrating the internal auditory meatus affecting the acoustic nerves. The authors believe this a very rare presentation of metastatic gastric disease.
authors.affiliation: Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: Ce
authors.initials: C
authors.lastname: Owers
authors.affiliation: Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: Dj
authors.initials: Dj
authors.lastname: Stewart
authors.affiliation: Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stone
authors.affiliation: Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: Cj
authors.initials: C
authors.lastname: Kelty