Lung adenocarcinoma metastastic lesion in the internal auditory meatus

Metastasis to the cerebellopontine angle (CPA) or internal auditory meatus (IAM) is rare.We report a rare case of a 69-year-old woman with metastatic lung adenocarcinoma, who presented with 2 weeks history of left-sided hearing loss and progressively worsening vertigo. Examination revealed a left-sided facial nerve palsy while pure tone audiometry (PTA) showed a new left-sided deafness. MRI showed a new enhancing soft tissue lesion in the left IAM, highly suspicious of new metastases from her progressive lung cancer, which contributed to her neuro-otological symptoms. Subsequent MRI scans 4 months later also showed new brain metastases. She continued to be managed with supportive palliative care in view of her extensive disease.