Carcinoid tumor of the middle ear containing serotonin and multiple peptide hormones. A case report and review of the pathology literature.
A 69-year-old man complaining of longstanding hearing loss and mild otorrhea was found to have a mass obliterating the external auditory canal and polypous tympanic mucosa with accompanying absence of the tympanic membrane and ossicular chain. Tumors excised from the external auditory canal and tympanum showed histologic features essentially characteristic of a carcinoid tumor: a ribbon or festoon arrangement of tumor cells, formation of anastomosing cords and glandular spaces, presence of numerous argyrophilic as well as argentaffin secretory granules within many of the tumor cells, and ultrastructural evidence of neurosecretory granules in the tumor cell cytoplasm. Immunohistochemically, the tumor was found to contain not only neuronal marker substances such as neuron-specific enolase, S-100 protein and chromogranin A, but also serotonin and multiple peptide hormones such as pancreatic polypeptide, glucagon, cholecystokinin and leucine-enkephalin. A review of the pathology of 17 previous cases of carcinoid of the middle ear suggested that this type of carcinoid may have a variegated hormone profile among carcinoids of foregut origin, and hormonally may resemble ileal carcinoid arising from the midgut, although their histogenetic origins may differ, because of frequent production of serotonin.
Hosoda
S
S
Laboratory of Pathology, Aichi Cancer Center Research Institute, Nagoya, Japan.
Tateno
H
H
Inoue
H K
HK
Isojima
G
G
Kondo
S
S
Konishi
T
T
D000368:Aged; D002276:Carcinoid Tumor / Q000378:metabolism* / Q000473:pathology; D004428:Ear Neoplasms / Q000378:metabolism* / Q000473:pathology; D004432:Ear, Middle; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D010455:Peptides / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism*
D006728:Hormones; D010455:Peptides; D012701:Serotonin