Gurung, UTse, ACorbridge, R2026-04-222026-04-222017https://hdl.handle.net/20.500.14572/5873U Gurung Lecturer, GMSMA of ENT Head and Neck studies, Tribhuvan University Teaching Hospital, Kathmandu, Nepal A Tse ENT registrar R Corbridge Consultant, Royal Berkshire Hospital, UKAbstract Adenocarcinoma of unknown primary presenting as metastasis to Meckel’s cave and bilateral internal auditory canals is rare. We report a case of a 65-year-old chronic smoker presenting with ontological symptoms and trigeminal neuralgia who, on neuroimaging, revealed metastatic deposits to bilateral internal auditory meatus (IAM) and also Meckel’s cave.en-USArticle