Contrast-enhanced T1-weighted axial image reveals bilateral nodular leptomeningeal enhancement within the central sulci. There is greater avid enhancement within the right canal than in the left with an additional focus of nodular enhancement in the left modiolus.įigure 3. Coronal contrast-enhanced T1-weighted images through the internal auditory canals. Multiple areas of hyperintense signal were identified within bilateral cerebral sulci and cerebellar folia, which pointed to the likely presence of leptomeningeal disease ( Figure 3).įigure 2. Considering these audiometric findings, a 3-tesla magnetic resonance imaging (MRI-3T) scan of the brain and internal auditory canals was immediately conducted, results of which demonstrated an 8 × 4 mm enhancing mass in the right internal auditory canal, as well as 2 small foci of enhancement in the left internal auditory canal ( Figure 2). Pure-tone audiogram revealing a downsloping mild to severe sensorineural hearing loss in the left ear and a profound loss in the right.ĭiagnostic testing. Audiometry ( Figure 1) was performed at the time of presentation, results of which revealed a mild to moderately severe sensorineural hearing loss in the left ear and a profound sensorineural hearing loss in the right.įigure 1. The external auditory canals were clear and patent, and both tympanic membranes appeared intact and clear. He had a 12 pack-year smoking history and quit smoking cigarettes 30 years prior to this examination. His current medications include tramadol, albuterol inhaler, ondansetron, folic acid, famotidine, lisinopril, atorvastatin, and metoprolol. Of note, he was receiving pembrolizumab immunotherapy for stage 4 metastatic nonsmall cell carcinoma of the lung. His medical history included hypertension, hyperlipidemia, and atrial fibrillation. There had been no recent history of noise exposure, air travel, head trauma, antecedent or concurrent upper respiratory infection, change in mental status, or other past ear-related issues. He denied any accompanying pain, tinnitus, facial weakness, or vertigo.
Hersh, MD, Lenox Hill Hospital/Northwell Health, 110 72nd Ave, Forest Hills, New York 11375 ( )Ī 73-year-old man presented with a 1-week history of aural fullness and sudden hearing loss in the right ear. The authors report that informed consent was obtained for publication of the images used herein. The authors report no relevant financial relationships. Sudden hearing loss linked to metastatic adenocarcinoma of the temporal bone. 1 Department of Otolaryngology, Lenox Hill Hospital/Northwell Health, New York, NYĢDepartment of Neurology, Southern Ocean Medical Center, Manahawkin, NJģDepartment of Radiology, Westchester Medical Center and New York Medical College, Valhalla, NY
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