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Middle ear neoplasms showing adenomatous and neuroendocrine components.

Middle ear adenomas are rare epithelial tumours. Reports indicate that neuroendocrine (carcinoid) tumours may also occur at this site, often in association with an adenomatous component. The clinico-pathological findings (including C.T. scan appearances) of such a 'mixed' neoplasm are presented together with a brief review of the few previously described cases. The importance of immuno-histochemistry and electron microscopy for accurate pathological diagnosis of these neoplasms is confirmed.

Adenoma↗

[Computer tomography in the diagnosis of ear neoplasms].

51 suspects for tumors of the ear were examined using computed tomography (CT). Indications and parameters are specified for CT of the temporal bone as well as direct and indirect signs of benign and malignant tumors originating primarily from the middle ear. There are differences in the CT picture of ear inflammation with proliferation, destruction of tissue and tumors of the ear. CT findings were verified visually during surgical interventions. High diagnostic efficacy of CT was confirmed.

Ear Neoplasms↗

[Glandular ear neoplasms].

A case of ceruminoma was described. The authors also presents actual opinions about glandular tumors of the middle and external ear, their classification and treatment.

Adult↗

[Methodological aspects of radiotherapy in the treatment of ear neoplasms].

During 1978 to 1988, 35 patients with ear carcinoma (22 men and 13 women, aged 30 to 74 years) were treated. In 62% cases the tumor originated from the external acoustic meatus, in 30% cases--from the postoperative cavity (in patients operated on for chronic inflammation), and in 8% cases it was a primary tumor of the concha auriculae. 77% of the patients developed the III or IV stage of disease and 71% of patients had squamous cell carcinoma. Six patients underwent radiation therapy (Group 1), nine-radiation therapy and subsequent surgery within 14 to 30 days after exposure (Group 2), and twenty patients were exposed first to surgery and then to postoperative radiation therapy (Group 3). All the patients were followed up for at least one year and eight of them--for not less than 5 years. At the present time survivors make 37% of all the patients. In the study only routine dose fractionation was used. Regional metastatic areas were also exposed to irradiation. It is stressed that efforts are needed to increase the local effect of ear tumor therapy. Indications and contraindications for radiation therapy are presented and protocols of radiation therapy are described.

Adult↗

[Topographic and anatomic markers of the temporal pyramidal bone and their role in the surgical treatment of ear neoplasms].

Topographic anatomical guide points were studied on 126 total preparations of the temporal bones. The relation of the temporal bone pyramid angles in sagittal and horizontal planes, the distance from spina suprameatum to the pyramid top, from spina suprameatum to promontorium, from promontorium to internal carotid artery with the shape of the skull has been established.

Adult↗

[Treatment results in external and middle ear malignant neoplasms of patients treated at the Laryngology Department of Medical University of Silesia between 1991-2001].

The authors present 18 patients with malignant neoplasms of the ear and temporal bone who were treated in the Clinic of Laryngology Medical University of Silesia in Katowice in the years 1991-2001. The most frequent was squamous cell carcinoma (11 patients--61%). The neoplasm was located on the auricle in 7 patients (39%), in the external auditory canal in 4 (22%) patients, in the middle ear in 5 patients (28%) and in 2 cases (11%) it was difficult to establish primary site. Ten patients (55.5%) were treated in stage T4. All patients had surgery and in advanced cases the radiotherapy was added. The best outcomes were in auricular neoplasms. The treatment results were much worse in neoplasms of the external auditory canal and the middle ear. Over 3 year follow-up in 10 patients (55%) with ear and temporal bone neoplasms shows no recurrence.

Adult↗

[Malignant neoplasms of external and middle ear].

INTRODUCTION: Neoplasms of external and middle ear are rare, which cause several problems in diagnosis and therapy. The purpose of the study was to analyze retrospectively patients with malignant neoplasms of the ear. METHODOLOGY: The study was carried out on 53 patients treated for malignant ear neoplasms in single institution during 25 years (1978-2002). RESULTS: The most frequent neoplasm was squamous cell carcinoma--36 cases (67.9%), then basal cell carcinoma--9 cases (16.9%). Neoplasm primarily involved auricle in 26 patients (49.1%), external auditory canal in 15 patients (28.3%) and middle ear in 12 patients (22.6%). They were classified according to Stell and McCormick (1985) as follows: stage I--29 tumours (54.7%), stage T2--15 tumours (28.3%), stage T3--9 tumours (17%). Facial nerve paresis occurred in 15 patients (28.3%). The most often treatment modality was surgery--32 persons (60.4%), then surgery followed by radiotherapy--17 persons (32.1%). The characteristics of neoplasms related to the site of location were described. The difficulties in precise histopathologic diagnosis and extent of disease were pointed out. RESULTS: Neoplasms of external and middle ear constitute a group of various histopathological and clinical tumours, which differ in diagnostic difficulties, treatment and prognosis. A diagnosis was often made in advanced stages of neoplasms, especially for middle ear tumours, that diminished a possibility of effective treatment.

Adult↗

Middle ear carcinoid: an indolent tumor with metastatic potential.

BACKGROUND: Neuroendocrine tumors of the head and neck region may present problems in diagnosis. Middle ear carcinoid is a rare, recently recognized tumor, which to date has not been reported to metastasize. METHODS: We report the case of a 64-year-old man with a 9-year history of recurrent middle ear neoplasm and ipsilateral cervical lymphadenopathy. A microscopic parathyroid tumor was also identified. The approach to the diagnosis of this unusual combination is presented. RESULTS: The patient had a neuroendocrine tumor metastatic to multiple unilateral cervical lymph nodes, which was morphologically identical to his recurrent middle ear neoplasm. The neoplasm had the morphologic, immunohistochemical, and ultrastructural features of a carcinoid tumor. CONCLUSIONS: This case illustrates that middle ear carcinoids may metastasize. We suggest that immunohistochemical studies be performed on all biopsy specimens from neoplasms of the middle ear, as distinction from the more common paraganglioma may be difficult on morphologic grounds alone.

Carcinoid Tumor↗

Tumors of the external ear.

A variety of medical specialists are exposed to patients who seek treatment of external ear neoplasms. They are uncommon occurrences, and malignancies of the external ear are even rarer. Only 1 patient in 10,000 with an ear complaint will have a pathologically proven malignancy of the external ear. Tumors of the external ear, both malignant and benign, commonly resemble one another. A timely and correct diagnosis is necessary to avoid affecting the external ear's ability to collect sound, but also to avoid the more morbid and mortal complications of an external ear malignancy. This paper briefly outlines the epidemiology of external ear tumors, their etiology, related histopathology, and treatment, which encompasses a myriad of modalities and specialties.

Ear Diseases↗

[Middle ear carcinoma].

Middle-ear cancer represents 5 to 10% of all ear neoplasms. Risk factors include chronic suppurative pathology of the middle ear and prior irradiation. Most malignant tumors are squamous-cell carcinomas. We report the case of a 51-year-old woman with this process. The ideal treatment is mastoidectomy or pterosectomy followed by radiotherapy. We made a bibliographic review of the clinical manifestations, diagnosis, treatment, and prognosis of middle-ear cancer. Five-year survival rates range from 25 to 50% in patients who undergo surgery and radiotherapy.

Carcinoma, Squamous Cell↗

Carcinoid tumour of the middle ear associated with systemic symptoms.

Carcinoid tumour is one of the rarest middle-ear neoplasms. We describe here a case of carcinoid tumour of the middle-ear cleft that presented with aural as well as systemic symptoms. Diagnostic difficulty was encountered using light microscopy, but electron microscopy revealed the neurosecretory granules.

Adult↗

Carcinoid tumour of the middle ear. A morphological and immunohistochemical study with comments on histogenesis and differential diagnosis.

Primary carcinoid tumours of the middle ear are extremely rare, only nine cases having been reported. However, their true incidence is probably greater, since they are very difficult or impossible to distinguish from adenomas and adenocarcinomas with conventional histological stains. We describe the clinical, histological, immunohistochemical and ultrastructural findings in a carcinoid tumour of the middle ear in a 50-year-old woman. Immunohistochemical studies on non-neoplastic middle ear mucosa undertaken to investigate the histogenesis of such tumours are also reported. Histologically, the tumour consisted of both solid areas and areas of tubular structures containing intraluminal mucus. All the tumour cells reacted with the anti-keratin antibody KL 1; some were argyrophil and reacted with antibodies against neuron-specific enolase, chromogranin A, Leu-7, serotonin, pancreatic polypeptide, glucagon and lysozyme. Electron microscopy revealed dense core granules in the tumour cells. Endocrine cells could not be detected in non-neoplastic middle ear mucosa. Pancreatic-polypeptide-like immunoreactivity was demonstrated immunohistochemically in all three other published cases of carcinoid tumour of the middle ear investigated for this peptide, and glucagon-like immunoreactivity was also exhibited by one of these. Since carcinoid tumours of the middle ear often, as in this case, exhibit some degree of glandular differentiation, immunohistochemical or electron-microscopic investigation to detect neuroendocrine differentiation is of particular importance in adenomatous middle ear neoplasms.

Carcinoma↗

Primary adenoma of the middle ear.

Primary neoplasms of the ear are indeed unusual. Adenomatous middle ear tumors are even more unusual and have been, in previous presentations, uniformly labeled adenocarcinoma. Radical therapeutic approaches have therefore often been recommended. More recent literature has confidently established the existence of the entity of benign primary middle ear adenoma. In two reports only twenty-three cases have been recorded. The purpose of this article is to add two such cases to the literature. Current concepts in diagnosis and histopathogenesis are presented. Treatment guidelines are suggested.

Adenoma↗

Rhabdomyosarcoma of the middle ear: a wolf in sheep's clothing.

A 3-year-old boy with inflammatory granulation tissue in the ear canal and typanometric evidence of middle-ear effusion was examined. Subsequently, rhabdomyosarcoma of the middle ear was diagnosed. The insidious, deceptive presentation of this common pediatric tumor in an uncommon location is discussed with indication that early diagnosis and aggressive multimodal antitumor therapy seems to be improving the hitherto gloomy prognosis for these highly lethal middle-ear-neoplasms.

Antineoplastic Agents↗