Malignant melanoma presenting as sudden onset of complete hearing loss

The authors describe a rare case of rapidly progressive bilateral hearing loss associated with carcinomatous meningitis secondary to a primary malignant melanoma of the lower limb 6 years previously. Carcinomatous meningitis is a relatively rare diagnosis, with the involvement of the eighth cranial nerve being present in only a small proportion of patients. Diagnosis relies on clinical suspicion (when multiple cranial nerve lesions occur), magnetic resonance imaging, and cerebrospinal fluid cytology.