The First Reported Case of Primary Intestinal-type Adenocarcinoma of the Middle Ear and Review of the Literature.

The First Reported Case of Primary Intestinal-type Adenocarcinoma of the Middle Ear and Review of the Literature.

Otol Neurotol. 2017 Aug 08;:

Authors: Nader ME, Bell D, Ginsberg L, DeMonte F, Gunn GB, Gidley PW

Abstract
OBJECTIVE: Adenocarcinoma of the middle ear is a rare entity that must be distinguished from other adenomatous tumors of the temporal bone. We present the first patient of an intestinal-type adenocarcinoma originating from the middle ear.
PATIENTS: A 58-year-old woman presented with an 8-year history of left otorrhea. Her middle ear effusions were quite thick and gummy. She underwent eight sets of pressure-equalization tubes within 3 years. In 2011, her physical examination identified a middle ear mass, and she underwent mastoidectomy. A middle ear adenoma was resected. She underwent an additional three mastoidectomies for recurrence, with pathology from the 4th mastoidectomy revealing a diagnosis of adenocarcinoma. Imaging, at that time, showed an extensive temporal bone and Eustachian tube tumor.
INTERVENTIONS: She underwent a left subtotal temporal bone resection, parotidectomy, infratemporal fossa resection, dural resection, and microvascular free flap reconstruction followed by postoperative proton beam radiotherapy.
MAIN OUTCOME MEASURES: The final pathology report revealed intestinal-type adenocarcinoma.
RESULTS: Treatment was successful and the patient remains disease free 4 years later.
CONCLUSION: This is the first report of an intestinal-type adenocarcinoma of the middle ear and temporal bone. This patient also illustrates the difficulty of accurate histologic diagnosis of adenomatous tumors of the middle ear.

PMID: 28796082 [PubMed - as supplied by publisher]

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