[An autopsy case of meningeal carcinomatosis with vestibulocochlear nerve disturbance as the first manifestation].

A 54-year-old man initially complained of frontal headache, right ear pain and tinnitus in May, 1985. This was followed by right facial palsy and hearing loss, and he was admitted to our hospital. Physical findings revealed right trigeminal nerve disturbance, left facial nerve palsy and bulbar palsy. The spinal fluid showed pleocytosis, increased protein, decreased glucose, markedly increased carcinoembryonic antigen and adenocarcinoma cells. Gastric carcinoma was revealed by an upper GI series. He was treated with chemotherapy. However, he die in August, 1985. Nodular metastases were discovered at the right internal acoustic meatus and other areas. Microscopically, signet-ring cell carcinoma had diffusely infiltrated at the subarachnoid space.