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Metastatic lesions in temporal bones were rare in the past, however, nowadays, they seem to be increasing. The primary sites of metastases to the temporal bones are known to be the breasts, lungs, kidneys, gastrointestinal tract, prostate gland, larynx, and thyroid gland. We present a case with peripheral facial paralysis as the only symptom of a metastasis to the temporal bone in a 73 year-old woman, and that peripheral facial paralysis was the first and only metastatic symptom in that case. This patient was initially diagnosed with Bell’s palsy. However, based on the pathologic findings, a further study revealed an adenocarcinoma of the lungs which spread to the temporal bone. Any metastatic diseases to the temporal bone should be considered as possible etiology in patients with a clinical history of malignant neoplasms presenting with common otologic or vestibular symptoms, especially with facial nerve paralysis.
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