P12 | Bilateral internal auditory canal and leptomeningeal metastasis of non-small cell lung carcinoma mimicking neurofibromatosis type 2
Year: 2025
Type: article
Study design: Case Report
Abstract: Premises: Metastatic carcinoma in the internal auditory canal (IAC) or cerebellopontine angle is extremely rare. The most common primary tumor is lung cancer, being also the primary site with the highest rate of bilateral occurrence of IAC metastasis. Meningeal metastasis occur more frequently in bilateral diseases versus unilateral ones. Clinical and radiological features of bilateral IAC lesions can mimic neurofibromatosis type 2 (NF2), since IAC metastases on MRI appear similar to vestibular schwannomas and bilateral vestibular schwannomas are pathognomonic of this genetic disease, according to Manchester criteria.Description of the Case report: A 64 year old man was admitted to our ward with rapid-onset leg paresthesia, cauda equina syndrome and bilateral hearing loss. The patient was misdiagnosed as having NF2 due to MRI findings of bilateral internal auditory canals nodules, reported as vestibular neurinomas, and numerous foci of pathological contrastographic impregnation on the whole spinal cord’s surface, interpreted as meningiomas. The rapid worsening of the symptoms lead to reconsideration of the diagnosis and it turned out the patient was affected by multimetastatic non-small cell lung carcinoma.Conclusions: Although metastatic tumors in the IAC are rare, clinicians should be aware of this possibility. Patients with rapid-onset hearing loss, tinnitus, vertigo or facial palsy with radiological diagnosis of bilateral schwannomas should be tested in order to rule out IAC metastasis and to achieve an early identification of a possible malignancy and its primary site.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413795290