Recurrence of cholesteatoma spreading widely under the skin of the temporal region : A case report

Abstract

We herein report a 50-year-old woman with recurrent giant cholesteatoma. She visited the clinic with a complaint of swelling on the right side of her head, which she had noticed for five years but had left untreated because of a lack of symptoms. Recently, an increase in size has been observed. Her medical history included surgery for cholesteatoma-related otitis media 20 years prior, raising concerns regarding recurrence. An examination and imaging confirmed a multiloculated cystic mass, which necessitated surgical excision. Typically, cholesteatomas expand within the temporal bone and are often involved in bone destruction. However, in this case, the mass extended subcutaneously, without accompanying bone destruction. This unusual progression may indicate that the thickened membrane of cholesteatoma acts as a defensive barrier. Through this case, we aim to deepen our understanding of the pathological characteristics and clinical course of cholesteatoma while reaffirming the importance of surgical approaches to prevent recurrence.