Lymphoma of the Internal Auditory Canal Presenting as Facial Palsy, Vertigo, and Hearing Loss

Ryou, Namhyung; Ko, Dong yn; Jun, Hyung Jin; Chae, Sung Won

doi:10.5152/iao.2015.1434

Cited by 5 publications

(5 citation statements)

References 4 publications

(4 reference statements)

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“…Two hundred seventy-two articles reported on 553 patients with otologic manifestations of hematologic malignancies, of which 255 (93.8%) were case reports and of OECBM level V evidence and 17 (6.2%) were case series and of OECBM level IV evidence (Supplement 3, http://links.lww.com/MAO/B834; Supplement 4, http://links.lww.com/MAO/B835) (4,5,7–10,13,14,19–282). While the largest proportion of articles originated in the United States (n = 83, 30.5%), the literature spanned countries across all continents.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Raymond,

Ottinger,

Rowley

et al. 2024

Otol Neurotol

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Objective To examine the otologic and neurotologic symptoms, physical examination findings, and imaging features secondary to hematologic malignancies. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases, including PubMed, Scopus, and CINAHL, were searched for articles including patients with otologic manifestations of leukemia, lymphoma and multiple myeloma. Data collected included patient and study demographics, specific hematologic malignancy, timing and classification of otologic symptoms, physical examination findings, imaging features and methods of diagnosis. Pooled descriptive analysis was performed. Results Two hundred seventy-two articles, of which 255 (93.8%) were case reports and 17 (6.2%) were case series, reporting on 553 patients were identified. Otologic manifestations were reported on 307 patients with leukemia, 204 patients with lymphoma and 42 patients with multiple myeloma. Hearing loss and unilateral facial palsy were the most common presenting symptoms for 111 reported subjects with leukemia (n = 46, 41.4%; n = 43, 38.7%) and 90 with lymphoma (n = 38, 42.2%; n = 39, 43.3%). Hearing loss and otalgia were the most common presenting symptoms for 21 subjects with multiple myeloma (n = 10, 47.6%; n = 6, 28.6%). Hearing loss and unilateral facial palsy were the most common otologic symptoms indicative of relapse in subjects with leukemia (n = 14, 43.8%) and lymphoma (n = 5, 50%). Conclusion Hearing loss, facial palsy, and otalgia might be the first indication of a new diagnosis or relapse of leukemia, lymphoma, or multiple myeloma. Clinicians should have a heightened level of suspicion of malignant etiologies of otologic symptoms in patients with current or medical histories of these malignancies.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Raymond,

Ottinger,

Rowley

et al. 2024

Otol Neurotol

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“…Additionally, there is often widespread enhancement observed in the meninges both above and below the tentorium cerebelli; this, however, was not observed [ 4 ]. Patients with lymphoma also experience facial weakness, hearing loss, and dizziness [ 4 , 5 ]. The presence of an unrelated middle ear infection and the atypical presentation of symptoms can cause a delay in a lymphoma diagnosis [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with lymphoma also experience facial weakness, hearing loss, and dizziness [ 4 , 5 ]. The presence of an unrelated middle ear infection and the atypical presentation of symptoms can cause a delay in a lymphoma diagnosis [ 5 ]. High-dose steroid treatment can result in a fast improvement in symptoms, often leading to delayed diagnosis and improvement of image findings [ 1 , 4 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patient in our case received both steroids and prophylactic antibiotics, making lymphoma hard to diagnose in this case but also a highly suspicious etiology. The patient also had continued enhancement of the geniculate ganglion, tympanic, and mastoid segments of the facial nerve on MRI, which is atypical for schwannoma, and raises inflammatory and neoplastic lesions higher on the differential [ 1 , 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Left-Sided Sensorineural Hearing Loss and Facial Weakness in a 35-Year-Old Patient: A Diagnostic Challenge and Case Report

Cardoso¹,

Hamade²,

Saigal³

et al. 2023

Cureus

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We present the case of a 35-year-old patient who presented with a three-month history of left-sided sensorineural hearing loss and left-sided facial weakness. Initial imaging suggested a schwannoma, and the patient underwent ten treatments of intra-tympanic steroid injections and antibiotics, and was scheduled for surgery. However, the planned schwannoma removal surgery with gamma-knife was aborted due to the absence of the previously identified mass on the pre-procedure MRI. Subsequent imaging revealed continued enhancement of the left internal auditory canal (IAC), leading to considerations of lymphoma, sarcoidosis, IgG4 disease, or other inflammatory condition. The patient's symptoms have significantly improved since and are currently being conservatively managed and monitored. However, the patient continues to show persistent findings on MRI. This case highlights the diagnostic challenges faced in identifying the underlying etiology of this patient and emphasizes the need for further investigations and multidisciplinary management in patients with similar presentations.

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“…To our knowledge, only 10 cases of primary lymphomas arising from the EAC have been reported [9]. Besides the EAC, primary lymphomas have been reported to develop in the internal auditory canal [10], middle ear [11], and mastoid cavity [12] in the temporal bone area, and among these, the mastoid and middle ear cavity are known as the most common primary focus of origin [13]. Since primary lymphoma in the EAC has highly nonspecific clinical presentations, this disease can often be misdiagnosed as otitis externa [14].…”

Section: Discussionmentioning

confidence: 99%

Unusual Tumors Obstructing the External Auditory Canal: Report of Two Cases

et al. 2019

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Primary tumors arising from the external auditory canal (EAC) are rare. We describe two cases of mass lesions within the EAC causing slowly progressive hearing loss without otorrhea or otalgia. Otoendoscopic examination demonstrated total obstruction of the EAC, and pure tone audiometry revealed conductive hearing loss. Based on the findings of the histopathologic examination, one patient was diagnosed with venous hemangioma that was treated using surgical resection, and the other patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) that was treated using external-beam radiation therapy. Although primary tumors in the EAC are rare, both benign tumors such as venous hemangiomas and malignant lesions such as DLBCL should be considered as possible differential diagnoses of mass lesions in the EAC. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Lymphoma of the Internal Auditory Canal Presenting as Facial Palsy, Vertigo, and Hearing Loss

Cited by 5 publications

References 4 publications

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Left-Sided Sensorineural Hearing Loss and Facial Weakness in a 35-Year-Old Patient: A Diagnostic Challenge and Case Report

Unusual Tumors Obstructing the External Auditory Canal: Report of Two Cases

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