Lymphoma of the internal auditory canal presenting as facial palsy, vertigo, and hearing loss

The combined symptoms of vertigo, hearing loss, and facial palsy indicate the presence of lesions in the internal auditory canal (IAC). Differential diagnoses, such as inner/middle ear infections and IAC neoplasms, can make the definitive diagnosis of IAC lymphomas challenging. Lymphomas can infiltrate the central nervous system at various sites; however, IAC involvement in metastatic lymphomas is very rare. Herein we report the case of a patient with IAC lymphoma presenting with aural fullness of the left ear and intractable otalgia followed by symptoms of facial weakness, hearing loss, and vertigo within 48 h. The uncharacteristic clinical manifestations and concurrent middle ear infection meant that the conclusive diagnosis of IAC lymphoma was delayed.