Sudden hearing loss due to internal auditory canal metastasis of Her2-positive gastric cancer: A case report

Abstract

Internal auditory canal (IAC) metastasis due to leptomeningeal carcinomatosis (LMC) from gastric cancer (GC) has rarely been reported. Early manifestation of symptoms, such as hearing loss, vertigo and facial paralysis, in cases of IAC metastasis due to LMC may facilitate the early detection of brain metastasis. To the best of our knowledge, the present study is the first to report IAC metastasis due to LMC in human epidermal growth factor receptor 2 (Her2)-positive GC. This study reports a case of an Her2-positive GC patient with LMC including IAC metastasis, who presented with acute sensorineural hearing loss, ipsilateral facial paralysis and vertigo during trastuzumab containing chemotherapy. The current study also discusses the early diagnosis and management of this complicated condition, demonstrating that clinical suspicion is key for a prompt diagnosis and proper management of LMC including IAC metastasis in Her2-positive GC.

Gastric cancer with brain metastasis and the role of human epidermal growth factor 2 status

“…Seven of these patients showed CNS metastases (2.33%) and six of the seven patients with CNS metastases showed HER-2-over-expression of their cancer. While acknowledging the limitations of a retrospective study, our 6 cases, as with the five patients previously described (7,(21)(22)(23), raise the hypothesis that HER-2-over-expressed GC may have similar behaviour of HER-2-positive breast cancer showing a predilection for brain metastases, which are rare in GE junction cancer.…”

“…This patient is alive and healthy 8 months after radiotherapy. These Authors (7,22,23) raise the hypothesis that HER-2-positivity may be associated with a possible propensity for CNS metastases. In conclusion, we have reviewed retrospectively the records of 300 patients with gastric or GE junction cancer.…”

“…These two patients died approximately 10 and 24 months after diagnosis, a very long time when compared with our patients. Kim et al (22) reported a case with internal auditory canal metastasis due to leptomeningeal carcinomatosis from HER-2 positive GC. The interval from the date of diagnosis of GC and leptomeningeal carcinomatosis was seven months, and the patient survival time following the CNS involvement was only two months.…”

Hearing loss due to metastasis of gastric cancer to temporal bone: A case report

“…Previous reports of hearing loss due to metastasis of gastric cancer are infrequent ( 2 , 6 ). Ohno et al ( 12 ) and Kim et al ( 13 ) reported cases of metastasis of gastric cancer to meningeal carcinoma, which resulted in hearing loss. Joo et al ( 14 ) reported a case of gastric cancer manifesting as a solitary metastasis in the cerebellopontine angle that mimicked acoustic neuroma and caused hearing loss.…”

“…All patients with suspected temporal bone cancer should be subjected to a full neurologic evaluation, including hearing test, electronystagmography and cerebrospinal fluid examination, which may aid in the diagnosis of meningeal carcinoma ( 16 ). Radiological imaging, including high-resolution CT and contrast-enhanced MRI are of importance, since the anatomy of the temporal bone hinders physical examination ( 13 ). Contrast-enhanced MRI is capable of revealing the extent of the tumor and differentiating the tumor from non-neoplastic soft tissue, while CT scanning enables a reliable assessment of any invasion of the wall of the internal carotid artery canal, jugular bulb and otic capsule ( 13 ).…”