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Solitary Metastasis of Pancreatic Carcinoma to Internal Auditory Canal

Cerebellopontine angle (CPA) lesions represent about 10% of all intracranial lesions. A large variety of lesions can present as CPA mass. Ninety percent of CPA lesions are either vestibular schwannomas or meningiomas, and among the remaining 10% CPA lesions, 1-2% represent metastatic lesions. Patients who develop metastatic CPA lesions usually have a known history of carcinoma. We present a case of pancreatic cancer metastasis to the internal auditory canal (IAC) initially diagnosed as a Bell's palsy. The patient had no history of cancer and facial paralysis was the first symptom of his disease. A literature review and discussion regarding evaluation of metastatic IAC and CPA lesions is presented.