title: [A Rare Case of Metastatic Brain Tumors in the Bilateral Cerebellopontine Angles].
abstract: We encountered a rare case of metastatic brain tumors in the bilateral cerebellopontine angles. The patient was a 61-year-old man, who visited an otorhinolaryngology clinic with complaints of rapidly progressing bilateral hearing impairment and facial palsy. The patient was referred to our hospital because tumorous lesions were suspected in the bilateral cerebellopontine angles on brain magnetic resonance imaging. Regarding tumor markers, the patient's cancer antigen 19-9 and carcinoembryonic antigen levels were high, which suggested metastasis. However, no abnormal findings other than abdominal lymph node enlargement were detected on whole-body examination, and no primary lesion was identified. The tumor in the right cerebellopontine angle was excised using the lateral suboccipital approach and subjected to pathological examination. It was diagnosed as an adenocarcinoma; thus, both lesions were considered brain metastases from a malignant abdominal tumor, and radiochemotherapy was administered to the patient. Unfortunately, the patient died after 89 days of treatment, and a pathological autopsy revealed that the primary lesion was a common bile duct tumor. No dural metastasis was noted in the brain or spinal cord; however, tumors were detected in the epiarachnoid space during surgery. Metastasis to the bilateral cerebellopontine angles occurred in the same period, which was indicative of ascending metastasis through the vertebrobasilar artery. Hence, we suggest that progressive bilateral hearing impairment and facial palsy were a consequence of brain tumors that had metastasized bilaterally to the cerebellopontine angles.
authors.affiliation: Department of Neurosurgery(Omori), School of Medicine, Faculty of Medicine, Toho University.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Node
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Harada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masuda
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kondo
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nemoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sugo
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D002530:Cerebellopontine Angle / Q000000981:diagnostic imaging*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D014057:Tomography, X-Ray Computed