Cancer Res Treat.  2015 Jan;47(1):110-114. 10.4143/crt.2013.079.

Bilateral Internal Auditory Canal Metastasis of Non-small Cell Lung Cancer

• Kim CH
• Shin JE
• Kim HJ
• Lee KY

• KMID: 2380396
• DOI: http://doi.org/10.4143/crt.2013.079

Abstract

We report on a patient with brain metastasis involving bilateral internal auditory canal from non-small cell lung cancer (NSCLC). A 49-year-old woman who had been diagnosed with NSCLC (T2aN1M0) complained of persistent vertigo and bilateral tinnitus for three months. The patient had refused all treatments, including surgery and chemotherapy; however, she sought alternative medicine. The patient's hearing loss showed rapid progression bilaterally, and rotatory vertigo with peripheral-type nystagmus developed. Magnetic resonance imaging of the brain showed irregular nodular enhancement within both internal auditory canals with leptomeningeal enhancement and multiple intracranial metastasis. The patient was treated with epidermal growth factor receptor-tyrosine kinase inhibitor, and the tumor showed partial response. This was a rare case of multiple brain metastases involving bilateral internal auditory canal from known NSCLC presenting with vertigo and hearing loss.

Keyword

Vertigo; Internal auditory canal; Neoplasm metastasis; Lung neoplasms; Hearing loss

MeSH Terms

Brain
Carcinoma, Non-Small-Cell Lung*
Complementary Therapies
Drug Therapy
Epidermal Growth Factor
Female
Hearing Loss
Humans
Lung Neoplasms
Magnetic Resonance Imaging
Middle Aged
Neoplasm Metastasis*
Phosphotransferases
Tinnitus
Vertigo
Epidermal Growth Factor
Phosphotransferases

Figure

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  Fig. 1. Pure tone audiometry shows sensorineural hearing loss on both sides (A), and bithermal caloric test shows canal paresis of 75% on the right side (B). SPV, slow phase velocity.

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  Fig. 2. (A) Chest X-ray shows a mass lesion in the right upper lobe (RUL) (arrow). (B) Computed tomography of the chest shows a 4.2-cm mass (thick arrow) in RUL with enlargement of ipsilateral hilar lymph nodes (thin arrow).

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  Fig. 3. Magnetic resonance imaging of the brain shows irregular nodular enhancement within both internal auditory canals with leptomeningeal enhancement (arrows) (A); multiple tiny rim enhancing parenchymal metastases (arrows) (B).

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  Fig. 4. Magnetic resonance imaging of the brain shows partial reduction of a metastatic mass in the bilateral internal auditory canals (arrows).

Reference

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