title: Solitary Metastasis to the Facial/Vestibulocochlear Nerve Complex: Case Report and Review of the Literature.
abstract: BACKGROUND
  Distant metastasis of mucinous adenocarcinoma from the gastrointestinal tract, ovaries, pancreas, lungs, breast, or urogenital system is a well-described entity. Mucinous adenocarcinomas from different primary sites are histologically identical with gland cells producing a copious amount of mucin. This report describes a very rare solitary metastasis of a mucinous adenocarcinoma of unknown origin to the facial/vestibulocochlear nerve complex in the cerebellopontine angle.
  
  
  METHODS
  A 71-year-old woman presented with several month history of progressive neurological decline and a negative extensive workup performed elsewhere. She presented to our institution with complete left facial weakness, left-sided deafness, gait unsteadiness, headache and anorexia. A repeat magnetic resonance imaging scan of the head revealed a cystic, enhancing abnormality involving the left cerebellopontine angle and internal auditory canal. A left retrosigmoid craniotomy was performed and the lesion was completely resected. The final pathology was a mucinous adenocarcinoma of indeterminate origin. Postoperatively, the patient continued with her preoperative deficits and subsequently died of her systemic disease 6 weeks after discharge.
  
  
  CONCLUSIONS
  The facial/vestibulocochlear nerve complex is an unusual location for metastatic disease in the central nervous system. Clinicians should consider metastatic tumor as the possible etiology of an unusual appearing mass in this location causing profound neurological deficits. The prognosis after metastatic mucinous adenocarcinoma to the cranial nerves in the cerebellopontine angle may be poor.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: M Shafie
authors.initials: MS
authors.lastname: Ariai
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Eggers
authors.affiliation: Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Caterina
authors.initials: C
authors.lastname: Giannini
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Colin L W
authors.initials: CL
authors.lastname: Driscoll
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: link.michael@mayo.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary*; D000368:Aged; D002530:Cerebellopontine Angle / Q000473:pathology; D003390:Cranial Nerve Neoplasms / Q000556:secondary* / Q000601:surgery; D005155:Facial Nerve Diseases / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009422:Nervous System Diseases / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods; D016896:Treatment Outcome; D000160:Vestibulocochlear Nerve Diseases / Q000473:pathology* / Q000601:surgery
keywords: Adenocarcinoma metastasis; Cerebellopontine angle; Facial/vestibulocochlear nerve complex