Sensorineural Hearing Loss as the Prominent Symptom in Meningeal Carcinomatosis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Identification of SNHL
2.3. Clinical Data
2.4. Systematic Review and Data Extraction
2.5. Statistical Analysis
3. Results
3.1. Demographics
3.2. Clinical Characteristics
3.3. Auxiliary Examination
3.4. Treatment and Prognoses
3.5. Systematic Literature Review
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Wasserstrom, W.R.; Glass, J.P.; Posner, J.B. Diagnosis and treatment of leptomeningeal metastases from solid tumors: Experience with 90 patients. Cancer 1982, 49, 759–772. [Google Scholar] [CrossRef]
- Le Rhun, E.; Rudà, R.; Devos, P.; Hoang-Xuan, K.; Brandsma, D.; Segura, P.P.; Soffietti, R.; Weller, M. Diagnosis and treatment patterns for patients with leptomeningeal metastasis from solid tumors across Europe. J. Neuro-Oncol. 2017, 133, 419–427. [Google Scholar] [CrossRef] [Green Version]
- Gleissner, B.; Chamberlain, M.C. Neoplastic meningitis. Lancet Neurol. 2006, 5, 443–452. [Google Scholar] [CrossRef]
- GBD 2019 Hearing Loss Collaborators. Hearing loss prevalence and years lived with disability, 1990–2019: Findings from the Global Burden of Disease Study 2019. Lancet 2021, 397, 996–1009. [Google Scholar] [CrossRef]
- Shen, T.Y.; Young, Y.H. Meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss. Am. J. Otol. 2000, 21, 510–512. [Google Scholar] [PubMed]
- Uppal, H.S.; Ayshford, C.A.; Wilson, F. Sudden onset bilateral sensorineural hearing loss: A manifestation of occult breast carcinoma. J. Laryngol. Otol. 2001, 115, 907–911. [Google Scholar] [CrossRef] [PubMed]
- Currie, L.; Tomma, A. Malignant melanoma presenting as sudden onset of complete hearing loss. Ann. Plast. Surg. 2001, 47, 336–337. [Google Scholar] [CrossRef]
- Boukriche, Y.; Bouccara, D.; Cyna-Gorse, F.; Dehais, C.; Felce-Dachez, M.; Masson, C. Sudden bilateral hearing loss disclosing meningeal carcinomatosis. Rev. Neurol. 2002, 158, 728–730. [Google Scholar] [PubMed]
- Wagemakers, M.; Verhagen, W.; Borne, B.; Venderink, D.; Wauters, C.; Strobbe, L. Bilateral profound hearing loss due to meningeal carcinomatosis. J. Clin. Neurosci. 2005, 12, 315–318. [Google Scholar] [CrossRef]
- Testoni, S.; Pirodda, A.; Pastore Trossello, M.; Minguzzi, E.; D’Alessandro, R. Meningeal carcinomatosis causing isolated bilateral symmetric progressive hearing loss. Neurol. Sci. 2005, 25, 345–347. [Google Scholar] [CrossRef]
- Jeffs, G.J.; Lee, G.Y.; Wong, G.T. Leptomeningeal carcinomatosis: An unusual cause of sudden onset bilateral sensorineural hearing loss. J. Clin. Neurosci. 2006, 13, 116–118. [Google Scholar] [CrossRef] [PubMed]
- Jariengprasert, C.; Laothamatas, J.; Janwityanujit, T.; Phudhichareonrat, S. Bilateral sudden sensorineural hearing loss as a presentation of metastatic adenocarcinoma of unknown primary mimicking cerebellopontine angle tumor on the magnetic resonance image. Am. J. Otolaryngol. 2006, 27, 143–145. [Google Scholar] [CrossRef]
- Suzuki, T.; Sakaguchi, H.; Yamamoto, S.; Hisa, Y. Sudden hearing loss due to meningeal carcinomatosis from rectal carcinoma. Auris Nasus Larynx 2006, 33, 315–319. [Google Scholar] [CrossRef] [PubMed]
- Lai, T.H.; Chen, C.; Yen, D.J.; Yu, H.Y.; Yiu, C.H.; Kwan, S.Y. Isolated acute hearing loss as the presenting symptom of leptomeningeal carcinomatosis. J. Chin. Med. Assoc. 2006, 69, 496–498. [Google Scholar] [CrossRef] [Green Version]
- Baba, S.; Matsuda, H.; Gotoh, M.; Shimada, K.; Yokoyama, Y.; Sakanushi, A. A case of meningeal carcinomatosis presenting with the primary symptoms of facial palsy and sensorineural deafness. J. Nippon. Med. Sch. 2006, 73, 240–243. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Koda, H.; Kimura, Y.; Iino, Y.; Eishi, Y.; Murakami, Y.; Kitamura, K. Bilateral sudden deafness caused by diffuse metastatic leptomeningeal carcinomatosis. Otol. Neurotol. 2008, 29, 727–729. [Google Scholar] [CrossRef]
- Vitaliani, R.; Spinazzi, M.; Del Mistro, A.R.; Manara, R.; Tavolato, B.; Bonifati, D.M. Subacute onset of deafness and vertigo in a patient with leptomeningeal metastasis from ovarian cancer. Neurol. Sci. 2009, 30, 65–67. [Google Scholar] [CrossRef]
- Gu, C.S.; Liu, C.Y.; Wang, M.C. Brain metastasis of nonsmall cell lung cancer presenting as sensorineural hearing loss and vertigo. J. Chin. Med. Assoc. 2009, 72, 382–384. [Google Scholar] [CrossRef] [Green Version]
- Mourgela, S.; Sakellaropoulos, A.; Ardavanis, A. Leptomeningeal carcinomatosis presenting as bilateral sensorineural deafness and unilateral facial palsy. J. BUON Off. J. Balk. Un. Oncol. 2009, 14, 317–319. [Google Scholar]
- Marchese, M.R.; La Greca, C.; Conti, G.; Paludetti, G. Sudden onset sensorineural hearing loss caused by meningeal carcinomatosis secondary to occult malignancy: Report of two cases. Auris Nasus Larynx 2010, 37, 515–518. [Google Scholar] [CrossRef]
- Ohno, T.; Yokoyama, Y.; Aihara, R.; Mochiki, E.; Asao, T.; Kuwano, H. Sudden bilateral sensorineural hearing loss as the presenting symptom of meningeal carcinomatosis of gastric cancer: Report of a case. Surg. Today 2010, 40, 561–565. [Google Scholar] [CrossRef] [PubMed]
- Bruce, B.B.; Tehrani, M.; Newman, N.J.; Biousse, V. Deafness and blindness as a presentation of colorectal meningeal carcinomatosis. Clin. Adv. Hematol. Oncol. 2010, 8, 564–566. [Google Scholar]
- Kato, Y.; Takeda, H.; Dembo, T.; Fukuoka, T.; Tanahashi, N. Progressive multiple cranial nerve palsies as the presenting symptom of meningeal carcinomatosis from occult colon adenocarcinoma. Intern. Med. 2012, 51, 795–797. [Google Scholar] [CrossRef] [Green Version]
- Öztürk, M.; Ila, K.; Düzgöl, C.; Akansel, G.; Almaç, A. Bilateral sudden sensorineural hearing loss caused by leptomeningeal carcinomatosis: Case report and review. Kulak. Burun. Bogaz. Ihtis. Derg. 2014, 24, 287–291. [Google Scholar] [CrossRef] [Green Version]
- del Pujol, E.D.M.; Kouassi, J.; Maire, J.P.; Franco-Vidal, V.; Darrouzet, V. Meningeal carcinomatosis of the internal auditory meatus: Clinical and imagery-aided differentiation. Otol. Neurotol. 2014, 35, 911–917. [Google Scholar] [CrossRef] [PubMed]
- Rakusic, Z.; Misir Krpan, A.; Stupin Polancec, D.; Jakovcevic, A.; Bisof, V. Sudden bilateral hearing loss in gastric cancer as the only symptom of disease. Targets. Ther. 2015, 8, 1285–1289. [Google Scholar] [CrossRef] [Green Version]
- Adams, M.; Doherty, C.; O’Kane, A.; Hall, S.; Forbes, R.B.; Herron, B.; McNaboe, E.J. Malignant meningitis secondary to oesophageal adenocarcinoma presenting with sensorineural hearing loss: A series of three cases and discussion of the literature. Eur. Arch. Oto-Rhino-Laryngol. 2016, 273, 2481–2486. [Google Scholar] [CrossRef] [PubMed]
- Costentin, G.; Richard, C.; Rouille, A.; Bourre, B.; Lefaucheur, R.; Grangeon, L. Sudden blindness and deafness disclosing meningeal carcinomatosis in non-small cell lung cancer. Acta. Neurol. Belg. 2019, 119, 491–492. [Google Scholar] [CrossRef] [PubMed]
- Kimura, A.; Takahashi, Y.; Mizutari, K.; Tsujimoto, H.; Nakanishi, K.; Shiotani, A. A Case of Gastric Meningeal Carcinomatosis Involving Bilateral Hearing Loss: The Difference between Clinical Images and Autopsy Findings. J. Int. Adv. Otol. 2019, 15, 333–336. [Google Scholar] [CrossRef] [PubMed]
- Tanaka, T.; Kanetaka, K.; Ikeda, T.; Yamaguchi, S.; Kawakami, S.; Kitajima, T.; Iwata, T.; Eguchi, S. A rare case of meningeal carcinomatosis and internal auditory canal metastasis presenting with the deafness for gastric cancer. Surg. Case. Rep. 2020, 6, 295. [Google Scholar] [CrossRef]
- Nakashima, K.; Demura, Y.; Oi, M.; Tabata, M.; Tada, T.; Shiozaki, K.; Akai, M.; Ishizuka, T. Whole-brain Radiation and Pembrolizumab Treatment for a Non-small-cell Lung Cancer Patient with Meningeal Carcinomatosis Lacking Driver Oncogenes Led to a Long-term Survival. Intern. Med. 2020, 59, 1433–1435. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Variable | Patients with SNHL (n = 8) | Patients without SNHL (n = 30) | p Value * |
---|---|---|---|
Male (%) | 6 (75.0%) | 14 (46.7%) | 0.238 |
Age (median (range)] (years) | 48 (37, 66) | 45 (15, 64) | 0.276 |
Initial symptoms | |||
headache | 7 (87.5%) | 20 (66.7%) | 0.395 |
visual impairment | 1 (12.5%) | 5 (16.7%) | 1.000 |
Other symptoms | |||
dizziness | 2 (25.0%) | 9 (30.0%) | 1.000 |
vomiting | 5 (62.5%) | 20 (66.7%) | 1.000 |
diplopia | 3 (37.5%) | 16 (53.3%) | 0.693 |
epileptic convulsions | 2 (25.0%) | 11 (36.7%) | 0.689 |
mental disorders | 2 (25.0%) | 7 (23.3%) | 1.000 |
impaired consciousness | 3 (37.5%) | 9 (30.0%) | 1.000 |
urinary retention | 0 | 5 (16.7%) | 0.337 |
limb weakness and numbness | 0 | 7 (23.3%) | 0.307 |
Damage of cranial nerves | |||
III (oculomotor) | 2 (25.0%) | 2 (6.7%) | 0.189 |
VI (abducens) | 6 (75.0%) | 4 (13.3%) | 0.002 |
VII (facial) | 4 (50.0%) | 2 (6.7%) | 0.012 |
Primary tumors | |||
lung adenocarcinoma | 4 (50.0%) | 12 (40.0%) | 0.698 |
stomach adenocarcinoma | 2 (25.0%) | 2 (6.7%) | 0.189 |
breast adenocarcinoma | 0 | 3 (1.0%) | 0.587 |
colon cancer | 1 (12.5%) | 0 | 0.211 |
Case | Air Conduction Threshold (dB) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Right Ear | Left Ear | |||||||||||||||
250 Hz | 500 Hz | 1000 Hz | 2000 Hz | 4000 Hz | 8000 Hz | PTA (Hz) | Magnitude | 250 Hz | 500 Hz | 1000 Hz | 2000 Hz | 4000 Hz | 8000 Hz | PTA (Hz) | Magnitude | |
1 | 75 | 65 | 70 | 75 | 90 | 105 | 75 | S | 85 | 80 | 85 | 75 | 90 | 85 | 83 | P |
2 | 105 | 105 | 100 | >120 | >120 | >120 | 111 | C | 75 | 80 | 85 | 80 | 90 | 105 | 84 | P |
3 | 90 | 85 | 85 | 80 | 75 | 75 | 81 | P | 10 | 15 | 10 | 15 | 15 | 20 | 14 | N |
4 | 110 | >120 | >120 | >120 | >120 | >120 | 120 | C | 65 | 70 | 55 | 60 | 65 | 50 | 63 | MS |
5 | 55 | 60 | 55 | 55 | 50 | 45 | 55 | MS | 30 | 35 | 45 | 55 | 60 | 70 | 49 | M |
6 | 75 | 100 | 90 | >120 | 100 | 105 | 103 | C | >120 | >120 | >120 | >120 | >120 | >120 | 120 | C |
7 | 105 | 110 | >120 | 100 | >120 | 100 | 113 | C | 70 | 75 | 80 | 80 | 85 | 90 | 80 | P |
8 | 55 | 50 | 60 | 55 | 70 | 65 | 59 | MS | 10 | 5 | 5 | 10 | 5 | 10 | 6 | N |
Author/Year | Age (Years) | Gender | Side of SNHL | Primary Tumor | Treatment | Outcome | |
---|---|---|---|---|---|---|---|
Shen TY et al. [5]/2000 | 51 | M | B | Lung cancer | NA | Died 1 year after diagnosis | |
Uppal HS et al. [6]/2001 | 61 | F | B | Breast cancer | Dexamethasone and tamoxifen | Died 11 weeks after presentation. | |
Currie L et al. [7]/2001 | 49 | F | B | Melanoma | Dexamethasone | Died 3 weeks after her original presentation | |
Boukriche Y et al. [8]/2002 | 59 | M | B | Bladder transitional cell carcinoma | Chemotherapy | NA | |
Wagemakers M et al. [9]/2005 | 52 | M | B | Esophagus adenocarcinoma | Radiotherapy of the skull base | Died 16 weeks after the onset of deafness. | |
Testoni S et al. [10]/2005 | 53 | M | B | Melanoma | NA | NA | |
Jeffs GJ et al. [11]/2006 | 66 | F | B | Melanoma | Steroid, urgent adjuvant radiotherapy | Her hearing loss did not improve. Died 2 weeks after the onset of hearing loss. | |
Jariengprasert C et al. [12]/2006 | 64 | F | B | Unknown | She refused any kind of treatment and consented to go back home. | Died 10 weeks after the onset of symptoms. | |
Suzuki T et al. [13]/2006 | 60 | F | B | Rectum adenocarcinoma | NA | Died 4 months after the diagnosis of MC. | |
Lai TH et al. [14]/2006 | 66 | M | B | Lung cancer | The family refused further treatment. | The patient was discharged the next day. | |
Baba S et al. [15]/2006 | 59 | M | R | Gastric cancer | NA | The patient became unconscious, and died 3 month after onset | |
Koda H et al. [16]/2008 | 63 | M | B | Esophagus adenocarcinoma | NA | Died of pneumonia 5 months after the onset of hearing loss. | |
Vitaliani R et al. [17]/2009 | 59 | F | R | Over carcinoma | Supportive therapy | She eventually became comatose and died 20 days after admission. | |
Gu CS et al. [18]/2009 | 59 | M | L | Lung adenocarcinoma | Chemoradiotherapy | NA | |
Mourgela S et al. [19]/2009 | 56 | M | B | Lung small cell cancer | Whole brain radiation therapy and methotrexate intrathecally | NA | |
Marchese MR et al. [20]/2010 | 56 | M | R | Pancreas cancer | NA | Died few days after the diagnosis of MC | |
64 | F | B | Unknown | Chemotherapy and stereotassic radiotherapy | Until now without clinical improvement. | ||
Ohno T et al. [21]/2010 | 62 | M | B | Gastric cancer | Radiation therapy to the whole brain and spine, chemotherapy with S-1 and paclitaxel | Deafness did not improve. Died 12 weeks after the onset of deafness. | |
Bruce BB et al. [22]/2010 | 65 | M | B | Colorectal cancer | Whole brain radiation | The patient’s clinical status deteriorated rapidly to death. | |
Kato Y et al. [23]/2012 | 77 | F | B | Colon cancer | NA | Died from cachexia 6 weeks after admission to our hospital. | |
Öztürk M et al. [24]/2014 | 44 | M | B | Duodenum adenocarcinoma | NA | NA | |
de Mones del Pujol E et al. [25]/2014 | 76 | F | R | Breast Adenocarcinoma | Radiotherapy to the whole brain | NA | |
60 | F | L | Breast and lung cancers | Radiotherapy to the whole brain | Died 1 month later with a bilateral encasement of the lower cranial nerves resulting from MC. | ||
42 | F | R | Unknown | Fractionated radiation therapy to the whole brain [46 Gy] was performed as an emergency, associated with intrathecal chemotherapy [methotrexate] | Eight weeks after treatment, hearing loss was improved. Died disease-free 6 years later after falling downstairs owing to her residual unsteadiness. | ||
61 | F | R | Lung cancer | whole-brain radiotherapy | Died of multiple metastases 14 months after hearing loss. | ||
67 | M | R | Melanoma | Chemotherapy with Temodal and whole-brain radiotherapy | NA | ||
77 | M | R | Unknown | No | Died 2 days after diagnosis, 2 months after the onset of symptom. | ||
Rakusic Z et al. [26]/2015 | 60 | F | B | Gastric cancer | No | Died 6 weeks from the first symptoms. | |
Adams M et al. [27]/2015 | 52 | M | B | Esophagus adenocarcinoma | A palliative approach | Died at home 21 days after presenting for assessment. | |
71 | M | B | Esophagus adenocarcinoma | A palliative approach | Died 42 days after initial presentation. | ||
43 | M | B | Esophagus adenocarcinoma | NA | The patient continued to deteriorate and died 1 month following initial presentation. | ||
Costentin G et al. [28]/2018 | 63 | F | B | Lung small cell cancer | Intravenous administration of high-dose corticosteroids and palliative care | Died a few days later. | |
Kimura A et al. [29]/2019 | 66 | M | B | Gastric cancer | NA | Died 46 days after the first onset of hearing loss. | |
Tanaka T et al. [30]/2020 | 68 | M | B | Gastric cancer | No | Died approximately two months after the symptom onset. | |
Nakashima K et al. [31]/2020 | 66 | F | B | Lung adenocarcinoma | Whole brain radiation therapy (30 Gy: 3 Gy × 10), chemotherapy with Pembrolizumab | Consciousness recovered. Brain MRI and CSF results were improved, although deafness remained. A total of 23 months have passed since the diagnosis of MC, and chemotherapy is ongoing (30 cycles) without disease progression. | |
The present cases | Case 1 | 38 | F | B | Lung adenocarcinoma | Focal radiotherapy and chemotherapy | Hearing loss improved, symptoms worse 5 weeks after treatment and died approximately four months after the symptom onset. |
Case 2 | 51 | M | B | Lung adenocarcinoma | Radiotherapy and palliative care | Died 50 days after the first onset of hearing loss. | |
Case 3 | 66 | M | R | Stomach adenocarcinoma | Whole brain radiotherapy | Hearing loss improved, cancer recurred 2 month after treatment and died 6 months after hearing loss. | |
Case 4 | 37 | M | B | Lung adenocarcinoma | Chemotherapy | Hearing loss did not improve. Died 15 weeks after the onset. | |
Case 5 | 56 | M | B | Unknown | Radiotherapy and chemotherapy | Hearing loss improved, disease-free 8 months later after acute coronary syndrome. | |
Case 6 | 54 | F | B | Lung adenocarcinoma | Radiotherapy to the whole brain | The patient’s clinical status deteriorated rapidly to death. | |
Case 7 | 38 | M | B | Stomach adenocarcinoma | Radiotherapy and chemotherapy | Died 17 weeks after onset. | |
Case 8 | 45 | M | R | Colon cancer | Focal radiotherapy and chemotherapy | Hearing loss recovered and brain MRI result was improved. Cancer recurred 6 month after treatment and died 8 month after initial presentation. |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Huang, X.; Jia, Y.; Jiao, L. Sensorineural Hearing Loss as the Prominent Symptom in Meningeal Carcinomatosis. Curr. Oncol. 2021, 28, 3240-3250. https://doi.org/10.3390/curroncol28050281
Huang X, Jia Y, Jiao L. Sensorineural Hearing Loss as the Prominent Symptom in Meningeal Carcinomatosis. Current Oncology. 2021; 28(5):3240-3250. https://doi.org/10.3390/curroncol28050281
Chicago/Turabian StyleHuang, Xiaoqin, Yu Jia, and Lidong Jiao. 2021. "Sensorineural Hearing Loss as the Prominent Symptom in Meningeal Carcinomatosis" Current Oncology 28, no. 5: 3240-3250. https://doi.org/10.3390/curroncol28050281