抄録
A 69-year-old female patient visited our clinic with the complaints of dizziness, recurrent otorrhea from the left ear, and worsening tinnitus. She had undergone Bondy’s operation on the left ear in her childhood. A granulomatous lesion was detected in the left mastoid antrum 7 years and 9 months after her first visit to our clinic. The first biopsy showed mild dysplasia with dyskeratosis. A second biopsy repeated 8 months later revealed well-differentiated squamous cell carcinoma. Temporal bone CT and MRI showed the temporal bone tumor almost invading the intracranial region. Superselective intra-arterial chemoradiotherapy was administered. However, two months after this therapy, partial resection of the temporal bone was performed because of suspected residual tumor. However, histopathology revealed no viable carcinoma cells within the resected specimen. The patient has shown no signs of recurrence until now, a year after the operation. Retrospective CT evaluation showed that the CT performed 2 years and 9 months before the appearance of the granulomatous lesion showed a slight thickening of the soft tissue in the mastoid antrum. In conclusion, it must be borne in mind that carcinoma can arise from chronic otitis media, and repeated biopsy should be performed in patients with suspected carcinoma. Temporal bone CT and otoscopy at regular intervals are recommended, so that the early signs of carcinoma development are not missed. In addition, our experience suggests that superselective intra-arterial chemoradiotherapy might possibly control advanced squamous cell carcinoma of the middle ear without surgery.
