Middle ear lymphoepithelioma-like carcinoma with cerebellopontine angle invasion misdiagnosed as meningioma: A case report and literature review.

Lymphoepithelioma-like carcinoma typically arises in the nasopharynx. Primary occurrence in the middle ear with subsequent intracranial extension remains exceedingly rare, and its diagnosis is often challenging owing to the paucity of detailed clinicoradiological data. Herein, we describe a case of an 82-year-old male presenting with a 2-year history of left-sided hearing loss, a 3-year history of left facial asymmetry (including mouth deviation and eyelid insufficiency), and a 10-day history of nausea/vomiting. His medical history included chronic otitis media. Imaging studies revealed a left cerebellopontine angle mass and chronic left otomastoiditis. Subtotal tumor resection was performed, and pathological analysis confirmed the diagnosis of lymphoepithelioma-like carcinoma. The patient received only supportive care and survived for 23 months. This case report aimed to emphasize the need for clinicians consider atypical cerebellopontine angle tumors in patients with chronic otitis media from Epstein-Barr virus-endemic regions and highlight the importance of a comprehensive diagnostic and therapeutic approach.