A case of unusual squamous cell carcinoma of the middle ear

Abstract

In September 1999, a 69-year-old woman was refered to our clinic, complaining of persistent pain of herright ear for 3 months. She received a radical mastoid surgery in her right ear when she was 3 years old, and the detail of this surgery was unknown. At the initial consultation, her ear cavity was well epithelizedand tumor or granuration tissure were not observed. CT imaging showed that a soft tissure density occupyingwhole mastoid cavity destructed the posterior and the lateral wall of the mastoid. In MRI imaging thissoft tissure was enhanced with Gadrinium, and a tumor lesion in the temporal bone was suspected. In November 1999, mastoidectomy was performed for pathological diagnosis, and the diagnosis wascholesteatoma both in frozen section and in permanent HE stainings. In order to resect most of the lesionand to establish the final diagnosis, subtotal tumor resection was conducted in December. Pathologicallymost of the mass consisted of fibrous granulation tissue containing kerarinizing squamous epithelium andthere was no evidence of malignancy. However, in a small amount of sampling from the mastoid cavity, atypical squamous cells with cancer peal were found and final diagnosis of squamous cell carcinoma wasestablished.
In this case malignant tumor was clinically suspected but the most part of the tumor was not pathologicallymalignant, and this factor delayed the final diagnosis.