CC BY-NC-ND 4.0 · Laryngorhinootologie 2020; 99(S 02): S297
DOI: 10.1055/s-0040-1711217
Abstracts
Otology

Bilateral hearing loss with meningitis carcinomatosa

Michael Aigner
1   Universitätsklinikum Augsburg, Hals-Nasen-Ohrenheilkunde, Augsburg
,
Elene Tsoures
1   Universitätsklinikum Augsburg, Hals-Nasen-Ohrenheilkunde, Augsburg
,
Paula Mangalo
1   Universitätsklinikum Augsburg, Hals-Nasen-Ohrenheilkunde, Augsburg
,
Johannes Zenk
1   Universitätsklinikum Augsburg, Hals-Nasen-Ohrenheilkunde, Augsburg
› Author Affiliations
 

Introduction Meningitis carcinomatosa with isolated vestibulocochlear symptoms is extremely rare. A retrospective multicenter study of gastric carcinomas with leptomeningeal involvement showed that only 3.7% had hearing loss and 1.95% had facial nerve palsy in the case of meningitis carcinomatosa. Headache (85.1%) and nausea (59.2%) are the most common symptoms.

Patient and diagnosis A 58-year-old female patient presents with progressive bilateral hearing loss and dizziness for two weeks. Anamnesis revealed a pancreatic carcinoma in 2012. At admission, both eardrums were dull and intact. A spontaneous nystagmus could not be detected. This was followed by inpatient admission of intravenous cortisone therapy. A hearing test revealed a deafness on the right. From the third day, a facial palsy developed on the right (House-Brackmann III). Initially, a cCT and a cranial MRI were performed. In both images no cause of the symptoms could be determined, which is why a lumbar puncture was performed. Here, there was a suspicion of a meningitis carcinomatosa as a result of pancreatic carcinoma. The patient was transferred to oncology and finally to the palliative care unit.

Conclusion In the case of therapy-resistant bilateral progressive hearing loss or facial palsy, a meningitis neoplastica should also be considered in the case of a previous tumor disease. In case of suspicion, an MRI should be performed before performing a lumbar puncture, as these lead to increased contrast media uptake in the meninges and thus make the diagnosis unnecessarily difficult.

Poster-PDF A-1633.PDF



Publication History

Article published online:
10 June 2020

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