-Case Reports-

A Case of Meningeal Carcinomatosis Presenting with the Primary Symptoms of Facial Palsy and Sensorineural Deafness

Shunkichi Baba, Han Matsuda, Minoru Gotoh, Ken-ichi Shimada, Yukiko Yokoyama and Atsuko Sakanushi

Department of Otolaryngology, Chiba-Hokusoh Hospital, Nippon Medical School

We report the case of a 59-year-old man with meningeal carcinomatosis (MC) who presented with peripheral facial palsy and progressive sensorineural deafness. The patient had been operated on for gastric cancer 1 year previously, and no metastases had been detected in the retroperitoneum or thorax at follow-up examination 1 year later. However, he developed headache, deafness, and peripheral facial palsy and was referred to us for further evaluation, as magnetic resonance of the head had shown no abnormalities. Ramsay Hunt syndrome was suspected, but no increase in the cerebrospinal fluid cell count was detected. On the other hand, the balance test suggested a central disorder. In addition, the plasma level of carcinoembryonic antigen suddenly increased, suggesting MC. The cerebrospinal fluid was examined several times; in the end malignant cells and an increase in the cell count were detected, and the diagnosis of MC was established.

J Nippon Med Sch 2006; 73: 240-243

Keywords
meningeal carcinomatosis, sensorineural deafness, peripheral facial palsy

Correspondence to
Shunkichi Baba, Department of Otolaryngology, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamakari, Inba, Chiba 270-1694, Japan
shbaba@nms.ac.jp

Received, April 20, 2006.
Accepted, June 23, 2006.