Primary papillary adenocarcinoma confined to the middle ear and mastoid.
Primary adenocarcinoma is a rare tumor of the middle ear and temporal bone; its most frequent symptoms are hearing loss, otalgia, and facial paralysis. Otoscopic examination of a 27-year-old man revealed purulent discharge in the ear canal, diffuse edema, and hypertrophy of the right tympanic membrane. He presented with a grade III (House-Brachman) facial paralysis and right conductive hearing loss with a history of aural discharge for 6 months, otalgia, and facial weakness for 2 days. Computed tomography of the temporal bone showed an opacity filling the tympanic cavity, antrum, and aditus. Tympanotomy revealed diffuse edema of the middle ear mucosa, and granulation tissue was encountered during mastoidectomy filling the antrum and periantral cells and eroding the fallopian canal at the level of the oval window. After the histopathological examination revealed papillary adenocarcinoma, a subtotal temporal bone resection, facial nerve segmenter resection, and end-to-end anastomosis of the facial with the hypoglossal nerves were performed. The importance of histopathological examination in all cases of chronic otitis media with granulation tissue is stressed.
Dadaş
B
B
Department of Otorhinolaryngology and Head and Neck Surgery, Sişli Etfal Education and Research Hospital, Istanbul, Turkey.
Alkan
S
S
Turgut
S
S
Başak
T
T
D000231:Adenocarcinoma, Papillary / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D004428:Ear Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D004432:Ear, Middle / Q000000981:diagnostic imaging / Q000473:pathology*; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D012720:Severity of Illness Index; D012888:Skull Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000473:pathology