Hearing loss as an unusual consequence of metastatic gastric adenocarcinoma

• Main Authors: CE Owers, DJ Stewart, J Stone, CJ Kelty
• Format: Article
• Language: English
• Published: Oxford University Press 2010-10-01
• Series: Journal of Surgical Case Reports
• Subjects: hearing loss; metastatic; gastric; adenocarcinoma
• Online Access: http://jscr.co.uk/2010/10/ent-surgery/hearing-loss-as-an-unusual-consequence-of-metastatic-gastric-adenocarcinoma/

A sixty-one year old man was referred with a history of progressive dysphagia, vomiting and weight loss with some back pain. Upper gastrointestinal endoscopy and biopsies revealed a gastro-oesophageal junction adenocarcinoma. Despite the absence of metastatic disease on computed tomography, positron emission tomography demonstrated multiple vertebral and sternal deposits. He was reviewed in an ENT clinic with a sudden onset of hearing loss accompanied by dizziness, but no focal neurology. Magnetic resonance imaging identified bilateral 2cm lesions at the internal auditory meatus, consistent with a diagnosis of bilateral acoustic neuromas. The patient subsequently died of carcinomatosis and, because of the potential familial significance of bilateral acoustic neuromas, a limited post-mortem examination was carried out. Unexpectedly, this revealed bilateral adenocarcinoma metastases infiltrating the internal auditory meatus affecting the acoustic nerves. The authors believe this a very rare presentation of metastatic gastric disease.