2013 Volume 136 Pages 99-103
Carcinoids (neuroendocrine tumors) are common in the gastrointestinal tract, respiratory tract, and lungs. There have been several reports of carcinoid tumors of the middle ear and larynx, but they are rarely found in the head and neck. We present herein on a case in which a tumor of the external auditory meatus was excised and diagnosed as a carcinoid tumor.
Case report: A 37-year-old male presented with earache of the left ear. A preliminary examination of the ear revealed a tender spherical swelling on the upper anterior wall of the external auditory meatus. Targeted CT imaging of the temporal bone showed a globular, 5 mm maximal dimension mass of soft tissue located against the tympanic membrane in the left external auditory meatus, with no obvious bone damage or spread to the tympanic cavity. The tumor was removed through a postauricular incision and biopsied. The pathology report found cord-like structured tumor cells under the external auditory meatal skin; immunohistochemical stains were positive for synaptophysin, CD56, and chromogranin A and negative for CD7, CD20, S-100. In addition, MIB-1 expression was approximately 4%. Based on these results, the mass was diagnosed as a well-differentiated neuroendocrine tumor consistent with a carcinoid tumor. As carcinoids of the hearing organs are rare, it was suspected that this was the result of metastasis, and the patient was given a full-body CT and referred to a pulmonologist and gastroenterologist. A thorough examination was conducted with MRI, GIF, and CF, and no abnormalities were found; the patient was then observed long-term. After one year, a thorough internal follow-up examination found no suspected primary tumors. One year after surgery, an internal ear examination was normal, and a CT showed no obvious signs of recurrence in the tympanic cavity or the area surrounding the external auditory meatus.
