Objective:

To present two cases of paraneoplastic cochleovestibulopathy (PCVP) associated with breast cancer and to review existing literature to enhance clinical awareness of this rare syndrome, which may lead to earlier diagnosis and treatment.

Key Findings:

• Both patients exhibited sensorineural hearing loss and vertigo as initial symptoms, indicating a potential early warning sign of underlying malignancy.
• Immunological tests indicated the presence of autoantibodies, although specific antibodies were not identified, complicating the diagnosis.
• Despite treatment with steroids and immunoglobulin, hearing loss did not improve significantly in either case, highlighting the treatment resistance of PCVP.
• Breast cancer was diagnosed in both patients following the onset of cochleovestibular symptoms, suggesting a possible paraneoplastic link.

Interpretation:

PCVP may be an underrecognized paraneoplastic syndrome associated with breast cancer, characterized by specific auditory and vestibular dysfunctions that are resistant to conventional treatments, necessitating further research.

Limitations:

• The rarity of PCVP limits the number of reported cases, hindering comprehensive understanding and generalizability of findings.
• The lack of identified specific autoantibodies complicates the diagnosis and understanding of the syndrome, suggesting a need for more extensive antibody panels.

Conclusion:

The cases underscore the need for heightened clinical awareness of PCVP in patients with unexplained cochleovestibular symptoms, particularly in the context of malignancies like breast cancer, to facilitate early diagnosis and intervention.