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Journal of Neurosurgery
 
Journal of Neurosurgery: Spine
 
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Neurosurgical Focus

Bilateral malignant melanoma metastases to the internal auditory canal/cerebellopontine angle: surgical management and preservation of function
Case report

Venelin M. Gerganov, M.D., Ph.D.1, Nirjhar Hore, M.D.1, Christian Herold, M.D.1, Karsten Wrede, M.D.1, Alexandru C. Stan, M.D., Ph.D.2, Amir Samii, M.D., Ph.D.1, and Madjid Samii, M.D., Ph.D.1
1International Neuroscience Institute–Hannover; and 2Department of Pathology, Medical University of Hannover, Hannover, Germany

Abbreviations used in this paper: CPA = cerebellopontine angle; CSF = cerebrospinal fluid; IAC = internal auditory canal; MR = magnetic resonance; NF2 = neurofibromatosis Type 2.

Address correspondence to: Venelin M. Gerganov, M.D., Ph.D., International Neuroscience Institute–Hannover, Rudolf Pichlmayr Strasse 4, Hannover 30625, Germany. email:

DOI: 10.3171/JNS/2008/108/4/0803

Although intracranial metastases of malignant melanomas are common, localization at the cerebellopontine angle (CPA) or in the internal auditory canal (IAC) is rare, and bilateral presentation especially so. We present the case of a 46-year-old Caucasian woman with bilateral IAC/CPA lesions and a prior history of malignant melanoma on the right leg. During preoperative investigations, the presence of the bilateral IAC/CPA lesions along with several radiologically identified lesions along the neural axis led to the suspicion that she had neurofibromatosis Type 2 despite her history of malignant melanoma and the lack of characteristic skin lesions and family history. Histopathological analysis of the resected lesion confirmed the intraoperative diagnosis of bilateral CPA malignant melanoma metastases. Surgical removal of the tumors via the retrosigmoid approach with preservation of normal bilateral facial nerve function and unilateral serviceable hearing, combined with control of the systemic disease, provided this patient with a near-normal quality of life for at least 42 months after the initial diagnosis of melanoma.

Keywords: cerebellopontine angle tumor; facial nerve; hearing preservation; internal auditory canal; melanoma; metastasis.

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