Meningeal carcinomatosis is the diffuse infiltration of the meninges by metastatic carcinoma. A 62-year-old man presented with a sudden onset of profound hearing loss affecting both ears. Brain magnetic resonance imaging showed increased signal intensity on T1-weighted images of both vestibulocochlear nerves. Upper gastrointestinal endoscopy revealed a large type 3 gastric cancer, and the pathological diagnosis was poorly differentiated adenocarcinoma. Although combination chemotherapy with oral S-1 and weekly paclitaxel and radiation therapy were performed, the patient's condition gradually worsened, and he eventually died 12 weeks after the onset of deafness. Isolated bilateral hearing loss is therefore considered to be a rare first manifestation of meningeal carcinomatosis.
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