A 48-year-old woman developed middle ear carcinoma after radical mastoidectomy. The left temporal bone was examined after 40Gy of irradiation.
A pathological study of the resected temporal bone revealed necrotic tissue and fibrous tissue in 80% of the middle ear. Carcinoma cells were observed in the tympanic sinus, round window niche, anterior wall of the external auditory meatus, and mastoid cells. Carcinoma was still present in the eustachian tube. Six months after surgery, the patient had a local recurrence. Ten months later, she died after cancer had invaded the brain.
Radiotherapy for middle ear carcinoma cannot be considered radical treatment. Multi-modal treatment, including subtotal temporal bone resection, is more effective than radiotherapy alone.