Cholesteatoma triggering squamous cell carcinoma: case report and literature review of a rare tumor.
BACKGROUND
The aim of this study was to report a case of squamous cell carcinoma of the petrous part of the temporal bone associated with a long history of secondary acquired cholesteatoma in a 71-year-old man.


METHODS
We present the case of a 71-year-old man diagnosed with secondary acquired cholesteatoma in 1950. Treatments consisted of repetitive surgery owing to several relapses. In 2004, he presented with progressive fetid otorrhea. Clinical and computed tomography findings were indicative for relapsing cholesteatoma and a subtotal petrosectomy was performed.


RESULTS
Histologic work-up demonstrated a moderately differentiated squamous cell carcinoma. The staging revealed stadium pT3 cN0 cM0. Postoperative treatment consisted of local radiation therapy with intensity-modulated beam geometry with a total of 64.2 Gy in 30 fractions using a simultaneous integrated boost.


CONCLUSIONS
Middle ear carcinoma can arise from acquired cholesteatoma. The pathogenesis of squamous cell carcinoma associated with cholesteatoma has not been elucidated satisfactorily. Due to the complex anatomic features, intensity-modulated radiation therapy is the technique of choice for postoperative radiotherapy.
Rothschild
Sacha
S
Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland. sacha.rothschild@insel.ch
Ciernik
I Frank
IF
Hartmann
Matthias
M
Schuknecht
Bernhard
B
Lütolf
Urs M
UM
Huber
Alexander M
AM
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002781:Cholesteatoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012888:Skull Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013701:Temporal Bone; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014433:Tympanoplasty / Q000379:methods