title: Malignant meningitis secondary to oesophageal adenocarcinoma presenting with sensorineural hearing loss: a series of three cases and discussion of the literature.
abstract: Malignant meningitis may rarely present to the otolaryngologist. We report our experience with 3 patients presenting with sudden, progressive bilateral sensorineural hearing loss secondary to malignant meningitis. The primary tumour in all 3 cases was oesophageal adenocarcinoma. All 3 cases were notable for the rapidity of the patients' clinical deterioration; the interval from presentation to death ranged from 21 to 28 days. We suggest that otolaryngologists should remain vigilant to the possibility of this devastating diagnosis and have a low threshold for further investigation in patients with suspicious features. It is important to note that initial MRI and lumbar puncture may be negative and repeat testing should be undertaken if there is clinical suspicion.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK. jadams08@qub.ac.uk.|Department of Otolaryngology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK. jadams08@qub.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Adams
authors.affiliation: Department of Neurology, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK.
authors.forename: Carolynne
authors.initials: C
authors.lastname: Doherty
authors.affiliation: Department of Neurology, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: O'Kane
authors.affiliation: Department of Neurology, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK.
authors.forename: Samuel
authors.initials: S
authors.lastname: Hall
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK.
authors.forename: Raeburn B
authors.initials: RB
authors.lastname: Forbes
authors.affiliation: Department of Neuropathology, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Herron
authors.affiliation: Department of Neurology, Craigavon Area Hospital, Portadown, Co Armagh, Northern Ireland, UK.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: McNaboe
mesh_terms: D000230:Adenocarcinoma / Q000150:complications*; D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications*; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D003639:Hearing Loss, Sudden / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055756:Meningeal Carcinomatosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D008875:Middle Aged
keywords: Hearing loss; Malignant meningitis; Oesophageal cancer; Sensorineural hearing loss