Solitary Metastasis of Gastric Carcinoma to the Cerebellopontine Angle

Internal auditory canal (IAC) and cerebellopontine metastases are very rare lesions and their diagnosis is very difficult due to their similarity to vestibular schwannoma in clinical characteristics and radiologic findings. Our case is peculiar and differs from previously reported cases of malignant metastasis to the IAC in two aspects: 1) solitary IAC metastasis occurred without distant metastasis and 2) symptoms due to IAC metastasis preceded outbreak of primary lesion symptoms or diagnosis of primary lesion. In our literature search, no correlating cases have been reported. In this peculiar case, rapid progression of otologic symptoms, short duration of onset from hearing impairment to facial palsy, and laterally eccentric contrast enhancement in gadolinium-enhanced T1-weighted magnetic resonance imaging may have been clues for metastatic lesion.