Rapid onset sensorineural hearing loss secondary to bilateral cerebral melanoma metastases to the cerebellopontine angle
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ENT Department, Wexham Park Hospital, U.K.
ENT Department, John Radcliffe Hospital, and Research Fellow, Nuffield Department of Surgery (University of Oxford), Oxford, U.K.
Neuroradiology Department, John Radcliffe Hospital, Oxford, U.K.
ENT Department, John Radcliffe Hospital, Oxford, U.K.
Rhona Sproat   

Rhona Sproat, ENT Department, Wexham Park Hospital, Wexham, Slough, Berkshire, SL2 4HL, U.K., Phone number: +44 01753 633 000; .e-mail:
Publication date: 2020-04-16
J Hear Sci 2014;4(1):41–46
We describe a case of bilateral cerebellopontine angle melanoma metastases in the context of a literature review. The case is a rare presentation of sensorineural hearing loss and an unusual site of metastasis for malignant melanoma.

Material and Methods:
A 54-year-old man presented with sudden deafness. Bilateral melanoma metastases were confirmed with MRI and lumbar puncture. He died 3 months after treatment.

Melanoma metastasis should be considered as a differential for sensorineural hearing loss. A review of the literature found that the median survival of patients with bilateral cerebellopontine angle metastatic melanoma is 6 months posttreatment. At surgery these tumours are largely unresectable from cranial nerves VII and VIII. Surgical intervention is unlikely to result in survival or symptomatic benefit and the focus of treatment should be on maintaining quality of life. Hearing rehabilitation and gamma knife surgery may have a role.

Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head and Neck Surgery, 2012; 146: S1–35.
Chau JK, Atashband S, Lin JRJ, Irvine RA, Westerberg BD. Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. Laryngoscope, 2010; 120: 1011–21.
Brackmann DE, Bartels LJ. Rare tumours of the cerebellopontine angle. Otolaryngol Head Neck Surg, 1976; 88: 555–9.
Gerganov VM, Hore N, Herold C, Wrede K, Stan AC, Samii A et al. Bilateral malignant melanoma metastases to the internal auditory canal/cerebellopontine angle: surgical management and preservation of function. Case Report. J Neurosurg, 2008; 108: 803–7.
Lee W, Weber PC. Melanoma metastasis masquerading as bilateral acoustic neuromas. Otolaryngol Head and Neck Surg, 2005; 132: 505–6.
Harbart F, Liu JC, Berry RG. Metastatic malignant melanoma to both VIII nerves. J Laryngol Otol, 1969; 83: 889–98.
Delerue O, Destee A, Devos P. Bilateral metastases in the cerebellopontine angle. J Neurol Neurosurg Psychiatry, 1991; 54: 562–3.
Tu AS, Wang H, Harris-McCorkle L, Saunders JR. Bilateral involvement of the cerebellopontine angles by malignant melanoma metastasis: a case report. Md Med J, 1994; 43: 967–70.
Arriaga A, William W, Brackmann D. Metastatic melanoma to the cerebellopontine angle. Clinical and imaging characteristics. Arch Otolaryngol Head Neck Surg, 1995; 121: 1052–6.
Shinogomi M, Yamasoba T. Bilateral isolated metastasis of malignant melanoma to the cerebellopontine angle. Otolaryngol Head and Neck Surg, 1998; 118: 276–9.
Brightman JA, Welling RP, Bradley D. Bilateral cerebellopontine angle metastatic melanoma: a case report. Ear Nose Throat J, 2007; 86: 388–90.
Brackmann DE, Doherty JR. CPA melanoma: diagnosis and management. Otol Neurotol, 2007; 28: 529–37.
Cancer Research UK. Skin Cancer Incidence Statistics. http://www.cancerresearchuk.or.... Published April 2013., Accessed accessed 19 May, 2013.
Amer MH, Al-Sarraf M, Baker LH, Vaitkevicius VK. Malignant melanoma and central nervous system metastases: incidence, diagnosis, treatment and survival. Cancer, 1972; 42: 660–8.
Navarette CM, Ruah CB, Schachern P, Paparella MM. Normal and metastatic melanin in the temporal bone. Am J Otolaryngol, 1995; 16: 33–9.
Eljamel S, Hussain M, Eligamel M. Should initial surveillance of vestibular schwannoma be abandoned? Skull Base Surg, 2011; 21: 59–64.
Raizer JJ, Hwu WJ, Panageas KS, Wilton A, Baldwin DE, Bailey E et al. Brain and leptomeningeal metastases from cutaneous melanoma: survival outcomes based on clinical features. Neuro Oncol, 2008; 10: 199–207.
Skeie BS, Skeie GO, Enger PØ, Ganz JC, Heggdal JI, Ystevik B et al. Gamma knife surgery in brain melanomas: absence of extracranial metastases and tumor volume strongest indicators of prolonged survival. World Neurosurg, 2011; 75: 684–91.