title: Middle ear metastasis from dormant breast cancer as the initial sign of disseminated disease 20 years after quadrantectomy.
abstract: We describe an unusual case of breast cancer metastatic to the middle ear in a 71-year-old woman. The metastasis was the initial sign of disseminated disease 20 years after the patient had undergone a quadrantectomy for her primary disease. Computed tomography (CT) demonstrated the presence of an intratympanic mass with a soft-tissue density that was suggestive of chronic inflammation. The patient underwent a canal-wall-down tympanoplasty. When a brownish mass was found around the ossicles, a mastoidectomy with posterior tympanotomy was carried out. However, exposure of the tumor was insufficient, and therefore the posterior wall of the ear canal had to be removed en bloc. Some tumor was left on the round window membrane so that we would not leave the patient with a total hearing loss. Our case highlights the limitations of CT and magnetic resonance imaging in differentiating inflammatory and neoplastic lesions.
authors.affiliation: Institute of Pathology, S. Maria del Carmine Hospital, Piazzale S. Maria 6, 38068 Rovereto (TN), Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pusiol
authors.forename: Ilaria
authors.initials: I
authors.lastname: Franceschetti
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonfioli
authors.forename: Francesco
authors.initials: F
authors.lastname: Barberini
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Scalera
authors.forename: Irene
authors.initials: I
authors.lastname: Piscioli
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000556:secondary*; D004428:Ear Neoplasms / Q000556:secondary*; D004432:Ear, Middle; D005260:Female; D006801:Humans; D013997:Time Factors