1/186. Middle ear adenocarcinoma with intracranial extension. Case report.Middle ear adenocarcinoma is a very rare, locally invasive neoplasm assumed to arise from the middle ear mucosa. Although endolymphatic sac tumor (aggressive papillary middle ear tumor) and jugulotympanic paraganglioma may show brain invasion, intracranial extension of histologically confirmed middle ear adenocarcinoma has not been previously reported. The authors describe a 53-year-old man who suffered from otalgia and tinnitus for more than 10 years and from neurological deficits for 1 year due to a large temporal bone tumor that invaded the temporal lobe. A combined neurosurgical and otolaryngological resection was performed. Pathological analysis revealed a low-grade adenocarcinoma of a mixed epithelial-neuroendocrine phenotype, which showed a close histological similarity to, and topographical relationship with, middle ear epithelium. The authors conclude that middle ear adenocarcinoma belongs to the spectrum of extracranial tumors that have possible local extension to the brain.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/186. Bilateral middle ear squamous cell carcinoma and clinical review of an additional 5 cases of middle ear carcinomas.We reported a retrospective review of the clinical records for a 64 year old male patient with bilateral middle ear squamous cell carcinoma (MESCC), and for the five other patients with MESCC treated at our institution during the last 20 years. The patient with bilateral MESCC has survived and remained tumor free for more than 1.5 years after extended radical resection of the secondary tumor combined with intra-arterial and systemic chemotherapy, radiotherapy and immunotherapy. Four patients with unilateral MESCC were treated with multidisciplinary treatment (induction chemotherapy, surgery and radiotherapy), and the remaining patient was treated with radiotherapy and mastoidectomy. Five of the six patients are alive with no evidence of disease. The patient treated with radiotherapy and radical mastoidectomy died of local recurrence 3 years after diagnosis. We suggest that MESCC should be considered when refractory granulation, long-standing otorrhea, otalgia and facial paralysis are observed. Multidisciplinary treatment, including intra-arterial chemotherapy and en bloc resection of the temporal tumor is useful for the treatment of MESCC and will improve the prognosis of patients with this disease.- - - - - - - - - - ranking = 1.125keywords = carcinoma (Clic here for more details about this article) |
3/186. facial paralysis: a presenting feature of rhabdomyosarcoma.The purpose of this paper is to present a child with embryonal rhabdomyosarcoma involving the left middle ear, who initially presented with unilateral facial paralysis. A 5-year-old boy presented with a 4-week history of left-sided facial weakness, associated with persistent otitis media on that side. Examination revealed complete left lower motor neuron facial weakness and hearing loss. A myringotomy revealed a soft tissue mass behind the tympanic membrane. biopsy and oncologic assessment confirmed a stage II, group III left middle ear embryonal rhabdomyosarcoma. Despite debulking surgery, local irradiation and multiple chemotherapeutic courses the child deteriorated quickly. He developed carcinomatous meningitis and died 9 months after his initial presentation. In conclusion, middle ear tumors should be considered in the differential diagnosis of unresolving otitis media, particularly when associated with persistent ipsilateral facial paralysis. An ear mass, discharge, facial swelling, or systemic symptoms may be initially absent despite the presence of this aggressive malignancy. Careful examination of the middle ear is recommended in children with facial weakness. A myringotomy incision may be necessary including a complete assessment of the middle ear cavity, particularly when there is no fluid return.- - - - - - - - - - ranking = 0.125keywords = carcinoma (Clic here for more details about this article) |
4/186. Malignant eccrine poroma in an elderly African-American woman.BACKGROUND: eccrine porocarcinoma is a rare, slow-growing malignant tumor arising from the eccrine sweat gland. OBJECTIVE: We present a case of eccrine porocarcinoma of the ear in an elderly African-American woman. Cases of eccrine porocarcinoma have been reported in the literature occurring in facial, extremity, scalp, and genital sites and primarily in Caucasian patients. Rarely are cases described in African-American patients or on the ear. methods: We describe the history of the lesion, discuss the current cancer statistics for skin cancer in african americans, and histology and treatment choices are compared with previously reported cases. RESULTS: We present a case of malignant eccrine poroma of the ear in a 71 year old African-American woman. The tumor was completely excised by mohs surgery. Transposition flap repair of the Mohs surgical defect was performed. CONCLUSIONS: While african americans are at low risk of developing skin cancers, it is important to remember that skin cancers can affect patients of any ethnicity and skin tone. Treatment regimens for skin cancers in African-American patients must be chosen appropriately by site of tumor, size of tumor and extent of disease as would be expected for any skin cancer.- - - - - - - - - - ranking = 0.375keywords = carcinoma (Clic here for more details about this article) |
5/186. Primary basal cell carcinoma of the middle ear presenting as recurrent cholesteatoma.OBJECTIVE: This study aimed to sensitize the practitioner to the unusual presentation of basal cell carcinoma in a recurrent cholesteatoma mass. STUDY DESIGN: The study design was a case report format. SETTING: The study was conducted at a tertiary referral hospital. PATIENT: The patient studied was a contralaterally anacusic veteran. INTERVENTION: Interventions were excision of cholesteatoma and withholding of adjunctive radiation. CONCLUSION: Primary basal cell carcinoma may present in a revision cholesteatoma field.- - - - - - - - - - ranking = 0.75keywords = carcinoma (Clic here for more details about this article) |
6/186. Pigmented squamous cell carcinoma with dendritic melanocyte colonization in the external auditory canal.A case of pigmented squamous cell carcinoma (SCC) with dendritic melanocyte colonization in the external auditory canal is reported and the previous cases are reviewed. A 65-year-old Japanese female was referred with a 7-year history of otitis. The patient also had a darkly pigmented 9 x 8 mm nodule in the external auditory canal. Microscopically, the tumor was SCC, but in some areas melanin pigments were found in the cytoplasm of the tumor cells. The tumor was thus diagnosed as pigmented SCC. As well as the tumor cells, dendritic-shaped cells colonized the tumor parenchyma and were immunohistochemically defined as melanocytes. The authors believe this is the first case of pigmented SCC with dendritic melanocyte colonization in the external auditory canal.- - - - - - - - - - ranking = 0.625keywords = carcinoma (Clic here for more details about this article) |
7/186. Rapidly invading sebaceous carcinoma of the external auditory canal.A very rare case of a sebaceous carcinoma of the external auditory canal with basal cell differentiation is presented. Fewer than 400 cases affecting any part of the body have so far been reported and of that only seven cases have been known to involve the external auditory canal. The clinical features, pathology and treatment are described and the relevant literature has been reviewed.- - - - - - - - - - ranking = 0.625keywords = carcinoma (Clic here for more details about this article) |
8/186. Squamous cell carcinoma of the external auditory canal: two cases treated with high dose rate 192Ir remote afterloading system (RALS).We report two cases of early-stage external auditory canal cancer treated by intracavitary irradiation with a high dose rate (HDR) 192Ir remote afterloading system (RALS) for preoperative treatment. A 6-Fr catheter for the HDR 192Ir remote afterloader, fixed by a plastic earplug, was inserted into the external auditory canal in two cases (case 1, T2N0M0; case 2, T1N0M0). The total intracavitary radiation dosages were 50 Gy (10 Gy/2 Fr/wk for 5 wks) for case 1, and 42 Gy (15 Gy/5 Fr/wk for 3 wks) for case 2. No external irradiation was given in either case. Surgical resection was performed in both cases, three to four weeks after irradiation. Histopathological examination confirmed the post-irradiation changes of necrosis, hyalinosis, and calcification, although vivid cancer cells remained. In preoperative irradiation of external auditory cancer, this method, although limited to treating early-stage cancers, may be a modality of choice for its efficacy and less severe side effects.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
9/186. Acute erythroid leukemia after cyclophosphamide therapy for multiple myeloma: report of two cases.The diagnosis of multiple myeloma was made in two white men, aged 55 and 59 years. They were treated with cyclophosphamide for 98 and 44 months respectively. Patient 1 also received a nine-month course of combined therapy with melphalan, procarbazine, and prednisone. Both developed acute erythroid leukemia, 98 and 71 months after the original diagnosis of myeloma, and died of subarachnoid hemorrhage and cardiac arrest. Patient 1 developed squamous cell carcinoma of the skin with recurrence, and Patient 2 developed anaplastic carcinoma of the urinary bladder. Palliative radiation therapy was given. The development of erythroid leukemia plus carcinoma in these two men suggests mutagenic change secondary to cyclophosphamide therapy.- - - - - - - - - - ranking = 0.375keywords = carcinoma (Clic here for more details about this article) |
10/186. Invasive verrucous carcinoma: a temporal bone histopathology report.Only nine cases of primary verrucous carcinoma of the temporal bone have been reported in the English literature. We describe histopathologic findings in a 78-year-old man dying of intracranial complications of primary verrucous carcinoma of the external auditory canal. Following autopsy the temporal bone was prepared for light microscopic examination. The temporal bone was serially sectioned horizontally after fixation, decalcification, and embedding, and each 10th section was stained with hematoxylin and eosin and examined by light microscopy. The carcinoma originated from the external auditory canal, infiltrating the mastoid cavity, the middle ear, tissue adjacent to the internal carotid artery, and the posterior cranial fossa, where it invaded the right cerebellum and produced an abscess. The labyrinth and internal auditory canal were not infiltrated. Metastasis to lymph nodes or distant sites was not identified. In the present case, the verrucous carcinoma originating from the external auditory canal extended into the posterior cranial fossa, while it did not invade the membranous labyrinth.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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