Meningeal carcinomatosis of lung cancer manifested as facial nerve palsy: case report and a literature review

A 79-year-old man presented with progressive right facial nerve palsy (FNP). He had pulmonary adenocarcinoma for 12 years and was treated with chemotherapy consisting of carboplatin plus paclitaxel. Neither an intracranial tumor nor cancer cells were detected in the brain image and the cerebrospinal fluid at the onset of FNP. Analysis of a second lumbar puncture demonstrated meningeal carcinomatosis 2 months after the first appearance of FNP symptoms, and the patient’s hearing subsequently became impaired and deteriorated. The patient was transferred to another hospital for end-of-life care 7 months after the first symptoms of FNP. This is a rare case of FNP caused by meningeal carcinomatosis and unusual because FNP preceded impaired hearing.