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Temporal bone secretory meningioma presenting as a middle ear mass.

A 44-year-old woman presented with a history of increasing left hypoacusis and sporadic vertigo. CT scan revealed a tumor occupying the mastoid, middle ear, and external auditory canal. After surgical removal, a typical secretory meningioma was diagnosed. The histological hallmark and the immunohistochemical profile of secretory meningiomas are reviewed. The differential diagnosis of this tumor in this location is also commented on. As far as we know, primary temporal bone meningiomas with secretory histology have not been previously reported in the medical literature.

Adult↗

Irradiation of the pinna with superficial kilovoltage radiotherapy.

Excellent local control can be achieved by treating superficial carcinomas of the skin with superficial kilovoltage radiotherapy. The results of this study support the use of 100-140 KV photons to treat carcinomas of the skin of or around the pinna. This achieves a local control rate of 97% and the radionecrosis rate of 10% could be halved if all patients were treated with 3500 cGy in 5 fractions over one week, or to a maximum area of 5 cm2 of irradiated pinna. An audit of the running cost reveals that this method of treating superficial carcinomas is highly cost effective and can be recommended for all suitable patients.

Aged↗

Cancer patients with large defects. Reconstructional options: a case study.

We report a case of a seventy-five years old male patient with a squamous cell carcinoma (SCC) originated from the right external ear four years ago. He was undergone surgical removal of the lesion with a combination of modified neck dissection and reconstruction with the use of pectoralis major flap. Furthermore, he had radiotherapy with 6000 rads of the right temporal region. Two months ago the patient showed an extended recurrence concerning the temporal muscle and bone, the lithoid bone, the masseter and the pterygoid muscles, the right part of the mandible, the parotid gland with the facial nerve, and the superior bulb of the internal jugular vein. He had a surgical removal of the lesion in extended healthy margins and functional and esthetic reconstruction of the defect with a combination of metal fixed prosthesis of the condyle and the right mandible and the use of myocutaneous trapezius flap. This is a case report of the reconstruction options we have nowadays to provide quality of life in cancer patients.

Aged↗

The place of 'salvage' petrosectomy.

Thirty-three of 58 patients with carcinoma of the external auditory meatus and middle ear were treated by radiotherapy. Nineteen patients suffered a recurrence. This proved to be unsuitable for petrosectomy in all patients with a tumour of the middle ear. A few patients with tumours of the external auditory meatus, usually of non-squamous variety, have survived for a reasonable period after 'salvage' petrosectomy.

Ear Neoplasms↗

Rhabdomyosarcoma of the middle ear and mastoid in children.

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.

Antineoplastic Combined Chemotherapy Protocols↗

Pilomatrixoma of the external auditory meatus.

Pilomatrixoma is a benign skin tumour arising from the outer hair root matrix. It is an uncommon tumour which favours the hair bearing area of the head and neck. The preauricular area is a well documented site, but to our knowledge, there are no reports of a pilomatrixoma arising in the external auditory meatus. We present such a case and discuss the historical background along with its pathological and clinical features.

Child↗

Merkel cell carcinoma of the pinna.

Merkel cell carcinoma is an increasingly recognized tumour of the skin. The commonest presentation is the head and neck region. Only three cases of this rare tumour have been reported on the pinna. A further such case is presented here.

Aged↗

A unique case of squamous cell carcinoma showing adenocarcinomatous features with focal apocrine differentiation.

We report an 85-year-old man with squamous cell carcinoma on the right pinna. Two years after the excision of the lesion, metastatic foci were found extending from the right retromandibular to the mastoid region and into the parapharyngeal space. Histopathologically, the primary tumor showed interconnecting nests of atypical cells invading into the dermis from multiple epidermal and infundibular foci. The tumor had both squamous and glandular differentiation. A peculiar finding was the presence of decapitation secretion in the glandular foci. To our knowledge, definite apocrine differentiation in squamous cell carcinoma has not previously been reported.

Adenocarcinoma↗

Bilateral spectacle frame acanthoma.

We report the case of a young white male with bilateral retroauricular spectacle frame acanthoma which developed within a few weeks of wearing ill-fitting sunglasses. Bilateral cases have only rarely been reported. This lesion must be differentiated from malignant proliferative conditions.

Adult↗

Stellate excision of malignancies on the auricles.

Primary excision of malignancies on the auricles with the standard "wedge technique" may produce lateral protrusion of the helix. A stellate-type excision eliminates the possibility of this undesirable effect and allows the surgeon to close large defects in the helix. The technique is described in detail.

Ear Neoplasms↗