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Avagnina A, Guinand N, Monnier Y, Dulguerov N. [Malignant external auditory canal tumors : management of a rare tumor]. Rev Med Suisse 2023; 19:1786-1790. [PMID: 37791692 DOI: 10.53738/revmed.2023.19.844.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Malignant tumors of the external auditory canal are rare tumors and very often diagnosed at an advanced stage due to non-specific symptoms. The best treatment is the radical surgery, eventually followed by radiotherapy. A multidisciplinary team is essential to realize an optimal management. Prognosis remains unfavorable for advanced tumors.
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Affiliation(s)
- Andrea Avagnina
- Service d'ORL et de chirurgie cervico-faciale, Département des neurosciences cliniques, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Nils Guinand
- Service d'ORL et de chirurgie cervico-faciale, Département des neurosciences cliniques, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Yan Monnier
- Service d'ORL et de chirurgie cervico-faciale, Département des neurosciences cliniques, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Nicolas Dulguerov
- Service d'ORL et de chirurgie cervico-faciale, Département des neurosciences cliniques, Hôpitaux universitaires de Genève, 1211 Genève 14
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2
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McGrath AM, Chen CL, Abrams B, Hixon L, Grimes JA, Viani E, McLoughlin MA, Tremolada G, Lapsley J, Selmic LE. Clinical presentation and outcome in cats with aural squamous cell carcinoma: a review of 25 cases (2010-2021). J Feline Med Surg 2022; 24:e420-e432. [PMID: 36066435 PMCID: PMC10812305 DOI: 10.1177/1098612x221119144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CASE SERIES SUMMARY Ear canal neoplasia is uncommon in cats. Ceruminous gland adenocarcinoma is the most frequently reported malignant neoplasm of the feline ear canal, and squamous cell carcinoma (SCC) is the most common malignant neoplasm diagnosed in the feline middle ear. However, limited information exists on the outcome of cats diagnosed with SCC of the ear canal, middle or inner ear. Therefore, the objective of this study was to describe the outcome of cats diagnosed with SCC affecting these locations. Medical records were reviewed at multiple institutions to identify cats with a definitive diagnosis of SCC. Twenty-five cats were identified. Eleven cats were treated with surgery, eight with medical management, two with coarse fractionated radiation therapy, two with a combination of coarse fractionated radiation therapy and chemotherapy, one with a combination of surgery and coarse fractionated radiation therapy, one cat with systemic chemotherapy and one cat received no treatment following diagnosis. The median survival time of cats treated with surgery was 168 days vs 85 days (P = 0.28) for those treated palliatively with either medical management, radiation therapy, chemotherapy, or a combination of radiation therapy and chemotherapy. RELEVANCE AND NOVEL INFORMATION This case series documented that SCC of the ear canal, middle and/or internal ear is a locally aggressive tumor that carries an overall poor prognosis. The median survival time for cats treated with surgery was longer than that with any other modality, but this difference was not statistically significant.
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Affiliation(s)
- Alysha M McGrath
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Carolyn L Chen
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA
| | - Brittany Abrams
- Department of Veterinary Clinical Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Leah Hixon
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA
| | - Janet A Grimes
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA
| | - Emily Viani
- Department of Surgery, Angell Animal Medical Center, Jamaica Plain, MA, USA
| | - Mary A McLoughlin
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Giovanni Tremolada
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Janis Lapsley
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Laura E Selmic
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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Fong PY, Tan TY, Kiong KL. Concurrent chemoradiation in locally advanced primary middle ear lymphoepithelial carcinoma: an effective treatment modality case report. J Otolaryngol Head Neck Surg 2021; 50:1. [PMID: 33407879 PMCID: PMC7788722 DOI: 10.1186/s40463-020-00489-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Definitive treatment of primary middle ear lymphoepithelial carcinoma (LEC) is not well established owing to the rarity of this disease entity. We report a case of locally advanced primary middle ear LEC treated with concurrent chemoradiation, with good oncologic outcomes. CASE PRESENTATION A 46 year-old female of Cantonese (Southern Chinese) descent presented with a four-month history of left sided hearing loss and non-pulsatile tinnitus, associated with progressive ipsilateral facial weakness. She had a left facial palsy (House-Brackmann 2) which then deteriorated to complete palsy over 2 weeks. Otoscopic examination of the left ear revealed a red-hued mass replacing the tympanic membrane. There was no cervical lymphadenopathy. Fibreoptic nasoendoscopy was unremarkable. Pure tone audiometry revealed profound mixed left hearing loss with type B impedance. Computed tomography of the temporal bone showed an ill-defined left middle ear mass with erosion of the malleus, tegmen tympani and facial canal. Magnetic Resonance Imaging showed an avidly enhancing lesion involving the dura of the left middle cranial fossa, tympanic and labyrinthine portions of the facial nerve. This mass extended into the apex of the left internal acoustic canal and basal turn of the cochlea. Histopathology confirmed EBV-positive primary middle ear LEC. Concurrent chemoradiation comprising 70Gy of intensity-modulated radiation therapy and 3 cycles of concurrent Cisplatin based chemotherapy over a 6 week period was administered. The patient achieved near-complete disease resolution on 3 month post-treatment imaging. Serum EBV DNA titres declined to undetectable levels and the patient is disease-free at 18 months post-diagnosis. DISCUSSION AND CONCLUSION Concurrent chemoradiation with curative intent may be a viable treatment option for locally advanced middle ear LEC not amenable to surgical resection due to expected surgical morbidity. It confers good oncologic outcomes that mimic the response in other head and neck EBV-related lymphoepithelial carcinomas.
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Affiliation(s)
- Pei Yuan Fong
- Department of Otolaryngology, SingHealth, 20 College Road, Level 5 Academia, Singapore, 169856, Singapore
| | - Tiong Yong Tan
- Department of Diagnostic Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Kimberley Liqin Kiong
- Department of Otolaryngology, SingHealth, 20 College Road, Level 5 Academia, Singapore, 169856, Singapore.
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Chew S, Gleeson JP, McCarthy A, Watson GA, O'Dwyer R, Nicholson S, Capra M, Owens C, McDermott M, Daly P, Grant C. Leptomeningeal Relapse of Embryonal Rhabdomyosarcoma after 15 years. Ir Med J 2020; 112:1026. [PMID: 32311247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aim Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumour of childhood. We present the case of a late relapse of RMS to the leptomeninges after 15 years. Methods A 20 year old male presented with a 3 week history of headaches and nausea. He previously had RMS of his right ear diagnosed at age 5 years which was treated with concurrent chemoradiotherapy. An MRI Brain and Spine confirmed extensive leptomeningeal disease and CSF analysis confirmed the presence of recurrent embryonal RMS. Results He completed two cycles of cyclophosphamide and topotecan followed by 45Gy/25Fr of craniospinal radiotherapy. Conclusion Late relapses beyond five years can be seen in up to 9% of patients, however very late recurrences (>10 years) are exceedingly rare. Molecular based methods such as gene expression profiling can aid risk stratification and survivorship clinics may become increasingly useful in following patients with high risk features.
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Affiliation(s)
- S Chew
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - J P Gleeson
- Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland
| | - A McCarthy
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - G A Watson
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - R O'Dwyer
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - S Nicholson
- Department of Histopathology, St James's Hospital, Dublin 8, Ireland
| | - M Capra
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - C Owens
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - M McDermott
- Department of Histopathology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - P Daly
- Department of Radiation Oncology, St James's Hospital, Dublin 8, Ireland
| | - C Grant
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
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5
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Mendenhall WM, Suárez C, Skálová A, Strojan P, Triantafyllou A, Devaney KO, Williams MD, Rinaldo A, Ferlito A. Current Treatment of Endolymphatic Sac Tumor of the Temporal Bone. Adv Ther 2018; 35:887-898. [PMID: 29923043 DOI: 10.1007/s12325-018-0730-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Indexed: 01/10/2023]
Abstract
An endolymphatic sac tumor (ELST) is a rare, indolent but locally aggressive tumor arising in the posterior petrous ridge. Patients present with sensorineural hearing loss and tinnitus. As the tumor progresses, patients may experience vertigo, ataxia, facial nerve paresis, pain and otorrhea. Most patients present in their 4th or 5th decade with a wide age range. Patients with von Hippel-Lindau disease have an increased likelihood of developing ELST. Histologically, ELST is a low-grade adenocarcinoma. As it progresses, it destroys bone and extends into adjacent tissues. The likelihood of regional or distant metastases is remote. The optimal treatment is resection with negative margins. Patients with positive margins, gross residual disease, or unresectable tumor are treated with radiotherapy or radiosurgery. Late recurrences are common, so long follow-up is necessary to assess efficacy. The likelihood of cure depends on tumor extent and is probably in the range of 50-75%.
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Affiliation(s)
- William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Carlos Suárez
- Instituto de Investigacion Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Alena Skálová
- Department of Pathology, Faculty of Medicine in Plzen, Charles University in Prague, Plzeň, Czech Republic
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Asterios Triantafyllou
- Department of Pathology, Liverpool Clinical Laboratories, University of Liverpool, Liverpool, UK
| | | | - Michelle D Williams
- Department of Pathology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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6
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Nervi C, Perrino A, Valente V, Cortese M. Protracted Intra Arterial Chemotherapy with Sequential Courses of Antimitotics and Radiotherapy in the Treatment of Extended Head and Neck Cancer. Tumori 2018; 54:199-219. [PMID: 4972134 DOI: 10.1177/030089166805400302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
51 patients with extensive inoperable head and neck cancer were treated with sequential continuous arterial infusion of anticancer agents. Mtx, 5 FUDR and Mitomycin C were administered in that order. At the end of the chemotherapy the patients were subjected to a full dose of external radiotherapy with the aim of destroying the residual cancer cells. Objective tumor regression was achieved in 27 patients lasting twice as long as in the same number of patients treated with external radiotherapy only. The study suggests that the idea of treating an extensive cancer with different drugs and therapeutic methods used sequentially with the aim of destroying the greatest number of cancer cells, is valid.
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7
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Warner E, Weston C, Barclay-Klingle N, Corbridge R. The swollen pinna. BMJ 2017; 359:j5073. [PMID: 29146730 DOI: 10.1136/bmj.j5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- E Warner
- Royal Berkshire Hospital, Reading, UK
| | - C Weston
- Royal Berkshire Hospital, Reading, UK
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8
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Tomas S. Management of the disappearing skin cancer. Aust Fam Physician 2015; 44:567-569. [PMID: 26510144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Steven Tomas
- MBBS (Hons), MMed, FRACGP Clinical Lecturer, University of Sydney, and General Practitioner, Gumtree Medical Practice, Dubbo, NSW
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9
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Nitze HR, Ganzer U, Vosteen KH. Synchronization of human tissues and its consequences for cancer therapy in ENT. Cell kinetic and clinical studies. Adv Otorhinolaryngol 2015; 21:82-155. [PMID: 4831897 DOI: 10.1159/000395090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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10
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Khaimook W, Plodpai Y. Malignant tumors of temporal bone in Songklanagarind Hospital: management and results. J Med Assoc Thai 2015; 98:273-278. [PMID: 25920298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the clinical course and treatment in patients with carcinoma of temporal bone MATERIAL AND METHOD The authors retrospectively reviewed the patients treated for primary carcinoma of temporal bone in Otolaryngology Head and Neck Surgery department, at Songklanagarind Hospital between 2002 and 2013. Thirty-two patients, including 10 cancer ofpinna and 22 carcinoma of the External Auditory Canal (EAC), were included in this study. The treatment modality was lateral temporal bone resection and postoperative radiotherapy and palliative radiotherapy for advanced stage tumors (T4). Twelve patients were excluded due to difference in modality. Twenty patients remained in the study. RESULTS Twenty patients had carcinoma of EAC, early stage (T1, T2) 36.4% and late stage (T3, T4) 63.6%. The overall survival of this group was 46.9%. The median survival period was 22 months (0.286-0.769, 95% CI). CONCLUSION The complete resection is the treatment of choice in primary cancer of temporal bone. Postoperative radiotherapy for a microscopic residual tumor is highly recommended. The most important thing is early diagnosis.
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Zhen S, Fu T, Qi J, Wen J. [Adenoid cystic carcinoma of external auditory canal: 8 cases report]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 29:343-345. [PMID: 26121835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To observe the clinical and pathological features of adenoid cystic carcinoma(ACC) of external auditory canal (EAC, and analyze the possible factors related to prognosis. METHOD One out of 8 patients with ACC of EAC underwent tumor open biopsy. 5 patients underwent the extensive tumor resection, and 2 patients underwent the modified lateral temporal bone resection (1 of the 2 subjoined a total parotidectomy). Five patients received the postoperative radiotherapy. RESULT The time of follow up was 5-97 months. Two patients were loss to follow-up, 5 patients with disease free survival, and 1 patient survival with tumor. CONCLUSION In this study, ACC of EAC is more often observed in female. The most common clinical manifestations are otalgia and neoplasm which grows slowly. The disease has high misdiagnosis rate. Surgical treatment is effective for it.
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12
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Hamamoto S, Okuma T, Yamamoto A, Kageyama K, Ueki A, Matsuoka T, Miki Y. Combination radiofrequency ablation and local injection of the immunostimulant bacillus Calmette-Guérin induces antitumor immunity in the lung and at a distant VX2 tumor in a rabbit model. J Vasc Interv Radiol 2014; 26:271-8. [PMID: 25443457 DOI: 10.1016/j.jvir.2014.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 09/03/2014] [Accepted: 09/04/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate whether the combination of radiofrequency (RF) ablation and local injection of the immunostimulant Mycobacterium bovis bacillus Calmette-Guérin (BCG) induces systemic antitumor immunity. MATERIALS AND METHODS Japanese White rabbits with lung and auricle VX2 tumors were randomized into three groups: control (n = 8; no treatment), RF ablation only (n = 8; RF ablation to the lung tumor), and RF ablation with local BCG injection into the lung tumor (n = 8). Treatments were performed 1 week after tumor implantation. Survival was evaluated with Kaplan-Meier method and log-rank test. Weekly mean volume and specific growth rate (SGR) of auricle tumors were calculated, and comparisons were made by Mann-Whitney test. RESULTS Median survival of control, RF-only, and RF/BCG groups were 23, 41.5, and 103.5 days, respectively. Survival was significantly prolonged in the RF-only and RF/BCG groups compared with the control group (P = .034 and P =.003, respectively), but no significant difference was found between the RF-only and RF/BCG groups (P = .279). Only in the RF/BCG group was mean auricle tumor volume decreased 5 weeks after implantation. No significant difference in SGR was found between the control and RF-only groups (P = .959), but SGR in the RF/BCG group was significantly lower than in the control group (P = .005). CONCLUSIONS The combination of RF ablation and local injection of BCG resulted in distant tumor suppression compared with the control group, whereas RF ablation alone did not produce this effect. Therefore, the combination of RF ablation and local injection of BCG may induce systemic antitumor immunity.
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Affiliation(s)
- Shinichi Hamamoto
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Tomohisa Okuma
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Akira Yamamoto
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan..
| | - Ken Kageyama
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Ai Ueki
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Toshiyuki Matsuoka
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Yukio Miki
- Department of Radiology, Osaka City University, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
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Chen J, Lu L, Qin D, Zhou H, Ma D, Li J, Gao X. [Clinical analysis of the treatment for benign tumor of external auditory canal by carbon dioxide laser under microscope]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1476-1478. [PMID: 25775749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the treatment for benign tumor of external auditory canal by carbon dioxide laser under microscope. METHOD Ten cases of benign tumor of external auditory canal were treated by carbon dioxide laser under microscope. The curative effects and complications were observed. RESULT Ten cases of benign tumor of external auditory canal were satisfied after operation without any complications. There were no recurrences during 3 months to 2 years of follow up. CONCLUSION The operation for benign tumor of external auditory canal by carbon dioxide laser under microscope was easy, safe and effective.
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Künzel J, Agaimy A, Hornung J, Lell M, Ganslandt O, Semrau S, Zenk J. Sporadic endolymphatic sac tumor--a diagnostic and therapeutic challenge. Int J Clin Exp Pathol 2014; 7:2641-2646. [PMID: 24966979 PMCID: PMC4069893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/29/2014] [Indexed: 06/03/2023]
Abstract
Endolymphatic sac tumor (ELST) is a rare low-grade locally aggressive neoplasm of the inner ear that may occur sporadically or in the setting of von Hippel-Lindau syndrome. We herein present a case of sporadic ELST in a 39-year-old man, treated using an interdisciplinary approach (surgery+radiotherapy), with a 10-year follow-up. The patient presented with hearing loss of sudden onset. The treatment of choice for ELST is radical tumor resection, which is associated with a good long-term prognosis. Remission may last for years, but there may be local recurrences, probably as a result of incomplete resection. Adjuvant radiotherapy is an option in case of recurrence and could be discussed after incomplete resection. The purpose of this report is to call attention to ELSTs, which are difficult to diagnose due to their rarity and variety of presentations.
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Affiliation(s)
- Julian Künzel
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Joachim Hornung
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Michael Lell
- Department of Radiology, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Oliver Ganslandt
- Department of Neurosurgery, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Sabine Semrau
- Department of Radiotherapy, University Hospital of Erlangen-NurembergErlangen, Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Erlangen-NurembergErlangen, Germany
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Hosokawa S, Mizuta K, Takahashi G, Okamura J, Takizawa Y, Hosokawa K, Yamatodani T, Mineta H. Carcinoma of the external auditory canal: histological and treatment groups. B-ENT 2014; 10:259-264. [PMID: 25654948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE Evaluation of the clinical and pathological factors associated with the treatment and outcomes of external auditory canal (EAC) carcinomas. METHODOLOGY A retrospective review of clinical and pathological analysis was performed on 23 patients who were histologically diagnosed with EAC carcinomas and treated at Hamamatsu University hospital. We evaluated the clinical staging, treatment methods, pathological diagnosis (particularly squamous cell carcinoma, SCC), and patient outcomes. Main outcome measures include staging, treatment procedures, pathological features, and estimated survival rates. RESULTS The 5-year overall survival (OS) of study participants was 75.2% and the 10-year OS was 60.2% using the Kaplan-Meier method. The prognosis for SCC was poor compared with other carcinomas (p= 0.0462). The prognoses for SCC patients after treatment with surgery alone and after postoperative radiotherapy or chemoradiotherapy were significantly better than for patients with unresectable tumours (p = 0.0004 and p = 0.0001, respectively). There was no significant difference among the four tumour stage groups. Information about patients' survival status was obtained after a median follow-up period of 57.5 months (range, 7-151 months). CONCLUSION Our survival analysis data for carcinoma of the EAC demonstrates that SCC and unresectable cases are associated with poor outcomes. Outcomes for patients with operable disease more closely parallel the survival curves of patients with advanced stage T4 disease. Patients with SCC should be strictly categorized as cases with severe disease.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- Carcinoma, Verrucous/pathology
- Carcinoma, Verrucous/therapy
- Chemoradiotherapy, Adjuvant
- Cohort Studies
- Disease-Free Survival
- Ear Canal/pathology
- Ear Neoplasms/pathology
- Ear Neoplasms/therapy
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Radiotherapy, Adjuvant
- Retrospective Studies
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Treatment Outcome
- Young Adult
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Zhao R, Wang J, Ba Y, Zhang Q. Metastasis germinomas of the external acoustic meatus: in a 19-year-boy: a case report. Int J Clin Exp Pathol 2013; 6:1416-21. [PMID: 23826424 PMCID: PMC3693208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 05/22/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND The external acoustic meatus metastasis of germinomas is a rare event. CASE PRESENTATION we describe a 19-year-old boy with stuffiness and earplug of the left ear but no other symptoms. The whole body F-18 FDG PET/CT and the brain MRI are performed and demonstrated a germinoma in the pineal gland and vermis cerebellum region and in the right of thalamus. Photomicrograph showing marked infiltration of lymphoplasma cells and macrophages including giant cells. Immunohistochemical analysis results demonstrated the tumor cells are strongly positive for CD117 and PLAP. The final diagnosis was germinoma and all adjuvant therapy was achieved. CONCLUSION Although the external acoustic meatus metastasis of germinomas is rare, the diagnosis should be taken into serious consideration in order to improve. In addition, F-18 FDG PET/CT was very useful in diagnosis primary disease and excluding distant metastases. To our knowledge, this is the first published report of this type of case.
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Affiliation(s)
- Rong Zhao
- Department of Nuclear Medicine, Urumqi General Hospital of Lanzhou Military RegionUrumqi, Xinjiang, 830002, China
| | - Jiang Wang
- Department of General Surgery, Urumqi General Hospital of Lanzhou Military RegionUrumqi, Xinjiang, 830002, China
| | - Ya Ba
- Department of Nuclear Medicine, The First Affiliated Hospital of Xinjiang Medical CollegeUrumqi, Xinjiang, 830002, China
| | - Qiong Zhang
- Medical Department, Urumqi General Hospital of Lanzhou Military RegionUrumqi, Xinjiang, 830002, China
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17
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Zulkarnaen M, Tang IP, Wong SL. Endolymphatic sac tumour. Malays J Pathol 2012; 34:53-55. [PMID: 22870599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.
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Affiliation(s)
- Mohammad Zulkarnaen
- Department of Pathology, Faculty of Medicine and Health Science, Universiti Malaysia Sarawak.
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18
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Cai Q, Xiao B, Tao Z, Hua Q. [Meta-analysis of the effects of radiotherapy and surgery on carcinoma of the middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 25:741-743. [PMID: 22070082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the effects of radiotherapy and surgery on carcinoma of the middle ear. METHOD A review of five published literatures was conducted according to defined selection criteria by the Review Manager 5.0 statistical software. RESULT There were no systematic reviews or large-scale RCTs between radiotherapy and symptomatic treatment containing surgery and radiotherapy for carcinoma of the middle ear. CONCLUSION Radiotherapy and symptomatic treatment for carcinoma of the middle ear have no obvious differences. The radiotherapy is the first choice for the treatment of squamous cell carcinoma of the middle ear.
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Affiliation(s)
- Qing Cai
- Department of Otolaryngology-Head and Neck Surgery, People's Hospital of Wuhan University, Wuhan, 430060, China.
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19
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Spagnoli V, Sirol M, Tournoux F. An unusual case of hypertensive cardiomyopathy. Arch Cardiovasc Dis 2011; 104:255-7. [PMID: 21624792 DOI: 10.1016/j.acvd.2010.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 06/22/2010] [Accepted: 07/05/2010] [Indexed: 11/18/2022]
Affiliation(s)
- Vincent Spagnoli
- Département de cardiologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
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20
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Bonaparte JP, Trites J, Hart R, Taylor SM. Survival when treating adenoid cystic carcinoma of the external auditory canal: quantitative assessment of case reports. J Otolaryngol Head Neck Surg 2009; 38:468-476. [PMID: 19755088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) of the external auditory canal is a rare neoplastic condition. The purpose of this study was to conduct a quantitative review of case reports to assess the efficacy of treatment options and assess prognostic factors. METHODS Cases were identified using PubMed. Kaplan-Meier curves were used to plot overall and disease-free survival. The log-rank test was used to compare survival curves in the univariate analysis for perineural invasion, margin status, and specific treatment modalities. A Cox proportional hazard model was used for multivariate analysis. RESULTS Sixty-six cases were identified. The univariate analysis suggests an increased overall (p = .03) and disease-free (p = .03) survival for those treated with parotidectomies, whereas temporal bone resection decreased survival (p = .07). There was no overall or disease-free survival advantage using radiation (p = .8). Positive margins decreased both overall (p = .05) and disease-free survival (p = .02). Perineural invasion was not significant. The multivariate analysis confirmed the findings for parotidectomies (p = .02) and temporal bone resections (p = .01). CONCLUSIONS Although the short-term survival for ACC is high, the risk of metastasis and poor long-term survival is high. In addition to local excision with negative margins, the surgeon should perform a parotidectomy.
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21
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Langer CJ, Duffy K, Horwitz EM, Litwin S, Rosvold E, Schol J, Keenan E, Nicolaou N, Friedman CD, Ridge JA. Phase I Trial of Concurrent Hyperfractionated Split Course Radiotherapy (HFx RT), Cisplatin (cDDP), and Paclitaxel in Patients with Recurrent, Previously Irradiated, or Treatment-Naïve Locally Advanced Upper Aerodigestive Malignancy. Cancer Invest 2009; 24:164-73. [PMID: 16537186 DOI: 10.1080/07357900500524421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Phase I study to determine the maximally tolerated dose (MTD) of cisplatin (cDDP), paclitaxel (P), and concurrent split course hyperfractionated (BID) RT in advanced squamous cell carcinoma of the head and neck (SCCHN) and other upper aerodigestive tumors. MATERIALS AND METHODS Eligibility stipulated ECOG performance status 0-2 and either Tx-naïve, locally advanced, or locally recurrent, previously radiated, surgically unresectable upper aerodigestive cancer. Metastases were permitted if disease was predominantly locoregional. RT-naïve patients received 150 cGy bid x 5 d Q 2 wks x 4. Previously radiated patients received 150 cGy bid x 5, wk 1; then 120 cGy bid x 5 Q 2 wk x 3 (later increased to 150 cGy BID for the entire treatment). Treatment fields included recurrent tumor only with 2 cm margins. Whenever possible, conventional and 3-D conformal techniques were used. Elective nodal radiation was not administered. Starting doses of cDDP and P were 12 mg/m2/d x 5 and 15 mg/m2/d x 5, respectively, Q 2 wk x 4, each given on RT days only. At dose level 2, cDDP was increased to 15 mg/m2/d x 5. At dose level 3, P was increased to 20 mg/m2/d x 5. Granulocyte colony stimulating factor (G-CSF) days 6-12 (off treatment week) was added if cumulative neutropenia precipitated treatment delays. RESULTS Thirty-one patients (21 men, 10 women) were treated. Eight had received prior chemotherapy, 27 prior RT. At dose level three, regular treatment delays of >or=1 week due to slow neutrophil recovery occurred. Addition of G-CSF (dose level 3b) reduced treatment delays from 100 percent to 28 percent and decreased the incidence of Grade >or=2 neutropenia and mucositis. Six of 7 patients at this dose level completed all 4 cycles of treatment and all received full dose RT (60 Gy). No other dose-limiting toxicities occurred. Of 22 assessable patients with locally recurrent SCCHN, 12 (55 percent) responded. Median time to progression in this group was 6 months, with median and one-year survival of 9.5 mos and 41 percent, respectively. CONCLUSION Concurrent daily cisplatin/paclitaxel and split course hyperfractionated RT (60 Gy) is feasible in previously radiated patients. G-CSF, administered between each cycle, reduces the incidence of treatment delays. Activity is promising and toxicity acceptable.
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Affiliation(s)
- Corey J Langer
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
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22
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Guinand N, Guyot JP, Kos I. [Jugular and tympanic paragangliomas]. Rev Med Suisse 2008; 4:2094-2097. [PMID: 18959077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Jugular and tympanic paragangliomas are the most frequent tumors of the middle ear. They appear as a reddish, pulsatile, retrotympanic mass. Patients complain from hearing loss and pulsatile tinnitus. Tumors are most often benign. Secretory forms are rare. Angio-MRI and CT-scan are gold standard. MIBG or octreotid scintigraphies are helpful to rule out multiple lesions. The treatment consists in surgery alone, radiotherapy alone or association of both. Often, embolisation prior to surgery decreases hemorrhagic risks. Vital prognosis is good. The functional outcome is critical in extensive tumors.
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Affiliation(s)
- Nils Guinand
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, HUG, 1211 Genève 14.
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23
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Mohindra S, Chhabra R, Mukherjee KK, Gupta SK, Mohindra S, Vashista RK. Contrasting behavior of endolymphatic sac tumors: a report of 2 cases and literature review. ACTA ACUST UNITED AC 2008; 69:175-80; discussion 180. [PMID: 17889284 DOI: 10.1016/j.surneu.2006.12.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Accepted: 12/14/2006] [Indexed: 10/22/2022]
Abstract
BACKGROUND Endolymphatic sac is an established source of low-grade neoplasms, posing a difficult problem in local tumor control. CASE DESCRIPTION Two cases of endolymphatic sac tumors are described in detail with regard to their clinical presentation and radiological findings. Both cases had diametrically opposite clinical outcomes in spite of repeated surgical interventions. A case with severe paraneoplastic syndrome and death after "cancer cachexia" is described. CONCLUSIONS Although endolymphatic tumors are known for their low-grade aggressiveness, in occasional cases, they may behave in a highly malignant behavior. The present communication highlights the contrast in clinical outcome and makes the clinician cautious of this special subgroup of tumors with a highly aggressive nature.
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Affiliation(s)
- Sandeep Mohindra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Ol'shanskiĭ MS, Korotkikh NG, Shcherbinin AS, Stepanov IV. [Combined treatment of auricular vascular neoplasms]. Vestn Otorinolaringol 2008:48-50. [PMID: 19008842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Two cases of combined treatment of auricular vascular neoplasms (arteriovenous malformation and hemangioma) are presented. Their two-step management included endovascular microembolization of the posterior auricular artery with polyvinyl alcohol (PVA 300, 500 mcm) and surgical resection of the tumour. The results confirm the feasibility of combination of traditional and endovascular surgery for the treatment of this pathology. Preoperative endovascular microembilization not only arrests hemorrhage from angiodysplasia but also decreases its size and isolates it from healthy tissues. Embolization of the posterior auricular artery can be performed only after the comprehensive angiographic evaluation of the blood flow in angiodysplasia and the adjacent vessels using superselective catheterization and officinal emboli.
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Abstract
To refine our therapeutic policy for intracanalicular tumors, we reviewed our series of patients who where initially treated conservatively. Forty-seven patients (22 men and 25 women) harboring an intracanalicular vestibular schwannoma were followed prospectively. Mean age at the time of inclusion was 54.4 (20-71) years. The mean follow-up period was 43.8 months (+/-40 months) ranging from 9 to 222 months. Failure was defined as significant tumor growth and/or hearing deterioration that required a microsurgical or radiosurgical treatment. Failure was observed in 35 cases while a conservative treatment is still ongoing in 12 patients. Ten patients kept an unchanged tumor size (21.3%), while 36 patients experienced a tumor growth (76.6%), and 1 patient experienced a mild decreased tumor size (2.1%). Among the 40 patients who where available for hearing level study, 24 patients (60%) did not change their Gardner and Robertson hearing class. Fifteen patients (37.5%) experienced a >10-dB hearing loss and 2 of them became deaf. One patient (2.5%) improved her hearing level from 56.3 to 43.8 dB over a 39.5-month follow-up period. These data suggest that the wait and see policy exposes the patient to degradation of hearing and tumor growth. Both events may occur in an independent way in the middle-term period. This information has to be given to the patient, and a careful sequential follow-up may be adopted when the wait and see strategy is chosen.
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Affiliation(s)
- Pierre-Hugues Roche
- Service de Neurochirurgie, Hôpital Sainte-Marguerite, Assistance Publique-Hôpitaux de Marseille, Marseille, France
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Abstract
AbstractWe report a rare case of primary B-cell lymphoma presenting as bilateral ear lobule swelling. A 56-year-old white man presented with a one-year history of painless swelling of both ear lobules. An excision biopsy confirmed B-cell lymphoma. Detailed systemic investigation confirmed the primary nature of the tumour. This tumour is rare in the ear lobule. A review of the English literature revealed no previously reported case of bilateral primary ear lobule involvement. Clinicians should be aware that this tumour can present as a primary in the ear lobules.
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Affiliation(s)
- A K Sharma
- ENT Department, Tameside General Hospital, Ashton Under Lyne, UK
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27
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Jagannathan J, Butman JA, Lonser RR, Vortmeyer AO, Zalewski CK, Brewer C, Oldfield EH, Kim HJ. Endolymphatic sac tumor demonstrated by intralabyrinthine hemorrhage. J Neurosurg 2007; 107:421-5. [PMID: 17695400 DOI: 10.3171/jns-07/08/0421] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
✓ Endolymphatic sac tumors (ELSTs) are locally invasive neoplasms that arise in the posterior petrous bone and are associated with von Hippel–Lindau (VHL) disease. These tumors cause symptoms even when microscopic in size (below the threshold for detectability on imaging studies) and can lead to symptoms such as hearing loss, tinnitus, vertigo, and facial nerve dysfunction. While the mechanisms of audiovestibular dysfunction in patients harboring ELSTs are incompletely understood, they have critical implications for management. The authors present the case of a 33-year-old man with VHL disease and a 10-year history of progressive tinnitus, vertigo, and left-sided hearing loss. Serial T1-weighted magnetic resonance (MR) imaging and computed tomography scans revealed no evidence of tumor, but fluid attenuated inversion recovery (FLAIR) MR imaging sequences obtained after hearing loss demonstrated evidence of left intralabyrinthine hemorrhage. On the basis of progressive disabling audiovestibular dysfunction (tinnitus and vertigo), FLAIR imaging findings, and VHL disease status, the patient underwent surgical exploration of the posterior petrous region, and a small (2-mm) ELST was identified and completely resected. Postoperatively, the patient had improvement of the tinnitus and vertigo. Intralabyrinthine hemorrhage may be an early and the only neuroimaging sign of an ELST in patients with VHL disease and audiovestibular dysfunction. These findings support tumor-associated hemorrhage as a mechanism underlying the audiovestibular dysfunction associated with ELSTs.
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Affiliation(s)
- Jay Jagannathan
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA
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Ogawa K, Nakamura K, Hatano K, Uno T, Fuwa N, Itami J, Kojya S, Nakashima T, Shinhama A, Nakagawa T, Toita T, Sakai M, Kodaira T, Suzuki M, Ito H, Murayama S. Treatment and Prognosis of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Multi-Institutional Retrospective Review of 87 Patients. Int J Radiat Oncol Biol Phys 2007; 68:1326-34. [PMID: 17446002 DOI: 10.1016/j.ijrobp.2007.01.052] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2006] [Revised: 01/17/2007] [Accepted: 01/24/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. METHODS AND MATERIALS The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). RESULTS The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. On univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). CONCLUSIONS Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary.
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Affiliation(s)
- Kazuhiko Ogawa
- Department of Radiology, University of the Ryukyus, Okinawa, Japan.
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29
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Viswanatha B. Embryonal rhabdomyosarcoma of the temporal bone. Ear Nose Throat J 2007; 86:218, 220-2. [PMID: 17500393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
The most common soft-tissue sarcoma in infants and children is rhabdomyosarcoma. The head and neck is the most common site of involvement; temporal bone involvement has been seen in about 7% of reported cases. Multimodality therapy--surgery, multiagent chemotherapy, and radiotherapy-yields sufficiently good results. The author reports a case of embryonal rhabdomyosarcoma of the temporal bone with cranial nerve palsies and extension into the parapharyngeal space in a 4-year-old boy. Despite surgery and chemotherapy, the patient died of his disease within 3 months of presentation.
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30
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Farhat M, Venugopal P. Long-term remission of extramedullary relapse from acute promyelocytic leukemia after treatment with arsenic trioxide, intrathecal chemotherapy, and brain irradiation. Clin Adv Hematol Oncol 2007; 5:320-3; discussion 323-4. [PMID: 17607291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Arsenic Trioxide
- Arsenicals/administration & dosage
- Cranial Irradiation
- Daunorubicin/administration & dosage
- Ear Neoplasms/cerebrospinal fluid
- Ear Neoplasms/diagnostic imaging
- Ear Neoplasms/genetics
- Ear Neoplasms/secondary
- Ear Neoplasms/therapy
- Humans
- Injections, Spinal
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/pathology
- Male
- Oxides/administration & dosage
- Radiography
- Remission Induction
- Sarcoma, Myeloid/cerebrospinal fluid
- Sarcoma, Myeloid/diagnostic imaging
- Sarcoma, Myeloid/etiology
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/therapy
- Tretinoin/administration & dosage
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31
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Nakagawa T, Kumamoto Y, Natori Y, Shiratsuchi H, Toh S, Kakazu Y, Shibata S, Nakashima T, Komune S. Squamous cell carcinoma of the external auditory canal and middle ear: an operation combined with preoperative chemoradiotherapy and a free surgical margin. Otol Neurotol 2007; 27:242-8; discussion 249. [PMID: 16436996 DOI: 10.1097/01.mao.0000190463.88873.3d] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Treatment outcomes for squamous cell carcinoma of the temporal bone were evaluated regarding stage, therapeutic strategy, and prognostic factors. STUDY DESIGN Retrospective case review. SETTING University hospital and outpatient clinic. PATIENTS Twenty-five patients with primary squamous cell carcinoma of the external auditory canal and middle ear. INTERVENTION Preoperative chemoradiotherapy and radiotherapy were used in 7 of 12 patients. Lateral temporal bone resection was performed for the lesions not beyond the tympanic membrane. Subtotal temporal bone resection was chosen for lesions extending to the middle ear cavity when there was no invasion to the pyramidal apex, carotid canal, or dura or metastasis. Others were conservatively treated by chemoradiotherapy. When the performance status was poor or an agreement regarding the operation could not be reached, the treatment was modified. MAIN OUTCOME MEASURE Estimated survival rates. RESULTS The 3-year estimated survival for T1 and T2 lesions was 100%. The 5-year estimated survival for T3 and T4 lesions was 80% and 35%, respectively. The 5-year estimated survival improved up to 75% for T4 tumors with operation and 16% for those without operation after 47 months. The tumor-free surgical margin is significantly related to patient survival in T3 and T4 lesions. Multivariate analysis predicted that concomitant chronic otitis media and positive lymph nodes were significantly associated with poorer survival. CONCLUSION The tumor-free surgical margin was important to survival. When T4 lesions did not involve the pyramidal apex, carotid canal, dura, or any lymph nodes, the surgical intervention improved the estimated survival rate to a level as good as T3 lesions.
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Affiliation(s)
- Takashi Nakagawa
- Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
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32
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Doherty JK, Yong M, Maceri D. Endolymphatic sac tumor: a report of 3 cases and discussion of management. Ear Nose Throat J 2007; 86:30-5. [PMID: 17315832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
Patients with an endolymphatic sac tumor (ELST) typically present with palsy of cranial nerves VII and/or VIII; other presenting symptoms include hearing loss, otalgia, occipital headaches, cranial nerve palsies, vertigo, gait ataxia, tinnitus, and otorrhea. ELSTs are extremely vascular, and they can invade and destroy temporal bone. Because of these characteristics, they are often mistaken for glomus tumors of the skull base. We describe the clinical presentation, evaluation, and management of ELSTs based on our review of the limited literature and our experience with 3 adults who presented to our tertiary care referral center with large ELSTs. Although these patients presented late in the course of their disease, their symptoms were relatively minor. Preoperative tumor embolization was performed, anda near-complete resection was achieved via an extended transotic approach in all 3 patients. The facial nerve was preserved without transposition in the first patient, the second patient underwent a primary nerve anastomosis, and the third required a cable graft of the facial nerve. Postoperative radiation therapy was administered to 2 of these patients. Follow-up by MRI detected no evidence of recurrence in any of the 3 patients.
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Affiliation(s)
- Joni K Doherty
- Department of Otolaryngology-Head and Neck Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, USA.
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33
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Korotkikh NG, Ol'shanskiĭ MS, Shcherbinin AS, Stepanov IV, Alekseeva TV, Ovsiannikov IM. [Endovascular microembolization of the posterior auricular artery in comprehensive surgical management of capillary angioma of the floor of the auricle]. Angiol Sosud Khir 2007; 13:74-76. [PMID: 18385652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The article deals with the description of a rare clinical case wherein a 44-year-old female patient presenting with bleeding capillary angioma of the left auricle obstructing the auditory passage was fist subjected to endovascular microembolization of the posterior auricular artery by means of polyvinyl alcohol (PVA-500), followed by a second stage of virtually bloodlessly surgical removal of the tumour carried out five days thereafter. This case report once again points to feasibility of combined, i. e. endovascular and conventional surgical management of capillary angiomas. Preoperative microembolization of a bleeding haemangioma arrests haemorrhage from the tumour, resulting in the decreased size thereof, as well as leading to circumscribing the tumour from healthy tissue. Attention is paid to the fact that embolization of the auricular artery should be performed only after a thorough angiographic evaluation of the pattern of the blood flow in the tumour and adjacent vessels by means of the technique of selective catheterization and using only the officinal emboli.
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Affiliation(s)
- N G Korotkikh
- Operative Dentistry and Maxillofacial Surgery, Voronezh State Medical Academy, Voronezh Regional Clinical Hospital No1, Voronezh, Russia
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34
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Hersh SP, Harrison WG, Hersh DJ. Primary B cell lymphoma of the external auditory canal. Ear Nose Throat J 2006; 85:597-9. [PMID: 17044427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Temporal bone lymphomas are rare and typically metastatic neoplasms. We describe a case of primary B cell lymphoma that originated in the external auditory canal of an elderly woman. The diagnosis was based on histopathologic examination supplemented by immunophenotypic analysis. The patient was treated with external-beam radiation and remained disease-free throughout 9 years of follow-up. We also point out that the presence of non-Hodgkin's lymphoma in an unusual site may be an indication that the patient has an acquired immunodeficiency syndrome.
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Affiliation(s)
- Sheldon P Hersh
- Department of Surgery/Otolaryngology , New York Hospital Medical Center of Queens, Flushing, NY, USA.
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35
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Scurry WC, Isaacson JE, Fedok FG. New-onset facial paralysis and undiagnosed recurrence of cutaneous malignancy: evaluation and management. Am J Otolaryngol 2006; 27:139-42. [PMID: 16500480 DOI: 10.1016/j.amjoto.2005.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Indexed: 10/25/2022]
Abstract
Perineural invasion of cranial nerves, including the facial nerve by squamous cell carcinoma of the skin, is a poor prognostic factor for recurrent disease and disease-specific mortality. We discuss 2 patients who presented to the Otolaryngology/Head and Neck Surgery service with complete facial nerve paralysis and a history of skin cancer. Based on our experience with these patients, we recommend that patients who present with facial nerve paralysis and a history of cutaneous malignancy undergo aggressive management including early intervention and complete exploration of the facial nerve from the geniculate ganglion out to the periphery. Such rigorous care achieves the best possible oncologic outcomes for a proven aggressive disease.
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Affiliation(s)
- W Cooper Scurry
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Penn State University College of Medicine, Hershey, PA 17033, USA.
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36
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Abbas A, Awan S. Rhabdomyosarcoma of the middle ear and mastoid: a case report and review of the literature. Ear Nose Throat J 2005; 84:780, 782, 784. [PMID: 16408557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
We report a case of rhabdomyosarcoma of the middle ear and mastoid in a 3-year-old boy. The patient was treated according to Intergroup Rhabdomyosarcoma Study IV protocol (chemo- and radiotherapy), and he experienced a complete remission. However 7 months after the completion of treatment, he experienced a recurrence at the primary site that spread to the brain. Despite treatment, the patient died of progressive metastasis to the lung 4 months later.
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Affiliation(s)
- Akbar Abbas
- Department of Otolaryngology-Head and Neck Surgery, Aga Khan University Hospital, Stadium Rd., P.O. Box 3500, Karachi-74800, Pakistan
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37
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Abstract
An 86-year-old man presented with multiple papules on his face, neck, lips and ears 4 years after a left nephrectomy for renal cell carcinoma. Shave biopsies and excisions of the cutaneous lesions revealed findings consistent with metastatic renal cell carcinoma of clear cell type. The patient continued to present to the clinic over the next 3 years with similar eruptions, and biopsies continued to confirm renal cell carcinoma. During this time, metastases to the bone, lung, soft palate and posterior leg were also diagnosed. This case represents an unusual clinical presentation of metastatic renal cell carcinoma. It shows that a high index of suspicion should be maintained as cutaneous metastases can mimic other skin conditions.
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Affiliation(s)
- Cathy Lim
- Department of Dermatology, Concord Hospital, Sydney, New South Wales, Australia.
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38
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Abstract
Merkel cell carcinoma is a rare malignant tumor of the skin. The face and extremities are the most common locations. We present a case of Merkel cell carcinoma of the auricle in a 93-year-old man subsequently treated with surgery and radiotherapy. The clinical features, prognosis, and treatment of the Merkel cell carcinoma are discussed.
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Affiliation(s)
- Fabio Pagella
- Department of Otorhinolaryngology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
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39
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Westhofen M. [Main symptom otorrhea: diagnosis and therapy]. MMW Fortschr Med 2005; 147:36-7, 39. [PMID: 15977632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Otorrhea is an ambiguous symptom that underlies diverse clinical pictures. Fundamentally, the treatment of uncomplicated acute otitis externa and media can be carried out by the family physician. An ENT specialist should be definitely consulted in cases of complications or development of a chronic condition.
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Affiliation(s)
- M Westhofen
- Klinik für Hals-Nasen-Ohrenheilkunde und Plastische Kopf- und Halschirurgie am Universitätsklinikum Aachen
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40
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Abstract
Symptoms such as hearing impairment, tinnitus, or a disturbance in sense of balance can generally be attributed to non-neoplastic causes, such as otitis media, otosclerosis, or trauma. Less commonly, auricular signs and symptoms are the result of non-neoplastic and neoplastic space-occupying lesions. The external ear can be the site of development of squamous carcinomas and basal-cell carcinomas; the middle ear and inner ear can host metastatic deposits, and primary squamous carcinomas and adenocarcinomas. Most auricular malignant diseases occur in adulthood; only the rhabdomyosarcomas of the middle ear arise in children. Most malignant diseases of the auricular apparatus are treated by a combination of surgery (commonly including radical excision of temporal bone), radiotherapy, and chemotherapy.
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41
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Abstract
Only a small number of cases of bilateral carcinomas of the external ear canal have been described in the literature. We present the first case of a 72 year old male patient with a bilateral squamous cell carcinoma of the external ear canal at a very early stage. A computed tomography of the temporal bone revealed a well-pneumatized mastoid on both sides. Both external ear canals were filled with soft tissue without radiological signs of destruction of the adjacent bone. The carcinomas of the external ear canal were surgically removed using a canal-wall down technique and a selective neck dissection of regions II-IV. Histology confirmed a well differentiated squamous cell carcinoma of the external ear canal without lymph node metastasis on both sides (TNM classification: pT1 G2 N0 M0 R0). Bilateral radiation therapy with 59.4 Gy resulted in stenosis of both ear canals. Hearing rehabilitation was achieved with bone conductive hearing glasses. Diagnosis und therapy of bilateral external ear carcinomas are presented and discussed.
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Affiliation(s)
- S Shagdarsuren
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum
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42
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Gierek T, Majzel K, Zbrowska-Bielska D, Gołab L, Jezierska M. [Treatment results in external and middle ear malignant neoplasms of patients treated at the Laryngology Department of Medical University of Silesia between 1991-2001]. Otolaryngol Pol 2005; 59:183-7. [PMID: 16095085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The authors present 18 patients with malignant neoplasms of the ear and temporal bone who were treated in the Clinic of Laryngology Medical University of Silesia in Katowice in the years 1991-2001. The most frequent was squamous cell carcinoma (11 patients--61%). The neoplasm was located on the auricle in 7 patients (39%), in the external auditory canal in 4 (22%) patients, in the middle ear in 5 patients (28%) and in 2 cases (11%) it was difficult to establish primary site. Ten patients (55.5%) were treated in stage T4. All patients had surgery and in advanced cases the radiotherapy was added. The best outcomes were in auricular neoplasms. The treatment results were much worse in neoplasms of the external auditory canal and the middle ear. Over 3 year follow-up in 10 patients (55%) with ear and temporal bone neoplasms shows no recurrence.
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43
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Abstract
OBJECTIVES To describe middle ear carcinoma originating from the matrix of primary acquired cholesteatoma in a 43-year-old man and to discuss the relationship between middle ear carcinoma and cholesteatoma. STUDY DESIGN Case report. SETTING Department of Otolaryngology, Head and Neck Surgery of Niigata University Medical and Dental Hospital, which is a tertiary care center, Niigata, Japan. PATIENT A 43-year-old man demonstrated symptoms resembling those of cholesteatoma: facial palsy, gradually progressive hearing loss, and chronic draining of the right ear. Other objective findings also supported a finding of cholesteatoma, but a computed tomographic scan and magnetic resonance imaging scan showed a well-enhanced mass and extensive bony erosion in the middle ear. At surgery, a granulous tumor in the mastoid cavity was diagnosed as squamous cell carcinoma, and closely coexisting cholesteatoma was found. Surgical specimen demonstrated carcinoma and cholesteatoma in the same field. INTERVENTION Radiation and chemotherapy were performed followed-up by mastoidectomy. CONCLUSION Because middle ear carcinoma has a poor prognosis, it is important to detect lesions early. It is necessary to consider that middle ear carcinoma arises from not only chronic otitis media or surgical invasion but also from primary acquired cholesteatoma.
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Affiliation(s)
- Kuniyuki Takahashi
- Department of Otolaryngology, Niigata University Faculty of Medicine, Niigata, Japan.
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44
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Isipradit P, Wadwongtham W, Aeumjaturapat S, Aramwatanapong P. Carcinoma of the external auditory canal. J Med Assoc Thai 2005; 88:114-7. [PMID: 15960229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Carcinoma of the external auditory canal is one of the most inaccessible areas of the body. It is a rare malignant neoplasm with an aggressive nature and an overall poor prognosis. In a ten year period, 16 patients were treated in King Chulalongkorn Memorial Hospital. From TNM staging proposed by the University of Pittsburgh, the authors found T1 = 1, T2 = 6, T3 = 5, T4 = 4 cases. In 14 patients who were operated on (radical mastoidectomy in 8, lateral temporal bone resection in 5, sleeve resection in 1), 7 had cured (50%), 7 were recurrence. 6 cases of recurrence developed in patients with radical mastoidectomy, 1 case with lateral temporal bone resection. The overall cure rate in stage I-II = 85.71% (6/7) but only 11.11% (1/9) in the advanced stages (III-IV). The present data suggest that in early cancer (stage I-II) the lateral temporal bone resection with postoperative radiation is better than radical mastoidectomy with postoperative radiation.
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Affiliation(s)
- Permsarp Isipradit
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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45
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Pajor A, Stańczyk R, Durko T. [Malignant neoplasms of external and middle ear]. Otolaryngol Pol 2005; 59:251-6. [PMID: 16095097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Neoplasms of external and middle ear are rare, which cause several problems in diagnosis and therapy. The purpose of the study was to analyze retrospectively patients with malignant neoplasms of the ear. METHODOLOGY The study was carried out on 53 patients treated for malignant ear neoplasms in single institution during 25 years (1978-2002). RESULTS The most frequent neoplasm was squamous cell carcinoma--36 cases (67.9%), then basal cell carcinoma--9 cases (16.9%). Neoplasm primarily involved auricle in 26 patients (49.1%), external auditory canal in 15 patients (28.3%) and middle ear in 12 patients (22.6%). They were classified according to Stell and McCormick (1985) as follows: stage I--29 tumours (54.7%), stage T2--15 tumours (28.3%), stage T3--9 tumours (17%). Facial nerve paresis occurred in 15 patients (28.3%). The most often treatment modality was surgery--32 persons (60.4%), then surgery followed by radiotherapy--17 persons (32.1%). The characteristics of neoplasms related to the site of location were described. The difficulties in precise histopathologic diagnosis and extent of disease were pointed out. RESULTS Neoplasms of external and middle ear constitute a group of various histopathological and clinical tumours, which differ in diagnostic difficulties, treatment and prognosis. A diagnosis was often made in advanced stages of neoplasms, especially for middle ear tumours, that diminished a possibility of effective treatment.
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Affiliation(s)
- Anna Pajor
- Klinika Laryngologii, Uniwersytetu Medycznego w Lodzi
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46
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Schmerber S, Righini C, Soriano E, Delalande C, Dumas G, Reyt E, Lavieille JP. [The outcome of treatments for carcinoma of the external auditory canal]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:165-70. [PMID: 16366384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE A retrospective analysis of management and survival of patients treated for temporal bone carcinoma. PATIENTS AND METHODS Thirty patients underwent treatment for carcinoma of the temporal bone. Twenty-five squamous cell carcinomas, 1 melanoma, 2 basocellular carcinomas and 2 adenoid cystic carcinomas were treated. Thirteen patients were treated before for the same disease. RESULTS Staging revealed 12 T1 and T2, 6 T3 and 12 T4 tumours. The mean follow up was 5 years (2-276 months). The Kaplan Meier survival curves showed survival rates at 2 years of 82%, 67% and 32%, and at 5 years of 82%, 67% and 17%, respectively for the stages T1 or T2, T3 and T4. At the end of follow up at 9 years the survival rates were 66%, 66% and 17% for the stages T1 or T2, T3 and T4 respectively. Overall stages a complete remission was found in 65% and 23%, and deceased was 35% and 77%, respectively for the primary treatment group and the salvage surgery group. CONCLUSION Long-term prognosis of the carcinoma of the external auditory canal mainly depends on the stage and primary treatment. Surgery (lateral temporal bone or subtotal temporal bone resection, both in combination with a neck dissection and a parotidectomy) and adjuvant radiotherapy is the treatment of choice for part of stage T1 and all T2 and T3 tumours. The improved survival (65%) of patients treated de novo compared with those treated with salvage surgery (23%) suggests that early referral and aggressive primary surgical treatment with postoperative radiotherapy offer the greatest chance of cure.
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MESH Headings
- Adult
- Aged
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/therapeutic use
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Carcinoma, Adenoid Cystic/drug therapy
- Carcinoma, Adenoid Cystic/radiotherapy
- Carcinoma, Adenoid Cystic/surgery
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Basal Cell/drug therapy
- Carcinoma, Basal Cell/radiotherapy
- Carcinoma, Basal Cell/surgery
- Carcinoma, Basal Cell/therapy
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Squamous Cell/therapy
- Cisplatin/administration & dosage
- Cisplatin/therapeutic use
- Combined Modality Therapy
- Ear Canal/pathology
- Ear Neoplasms/mortality
- Ear Neoplasms/pathology
- Ear Neoplasms/radiotherapy
- Ear Neoplasms/surgery
- Ear Neoplasms/therapy
- Ear, Middle/pathology
- Female
- Fluorouracil/administration & dosage
- Fluorouracil/therapeutic use
- Follow-Up Studies
- Humans
- Male
- Melanoma/drug therapy
- Melanoma/radiotherapy
- Melanoma/surgery
- Melanoma/therapy
- Middle Aged
- Neck Dissection
- Neoplasm Staging
- Parotid Gland/surgery
- Petrous Bone/surgery
- Prognosis
- Radiotherapy, Adjuvant
- Retrospective Studies
- Skull Neoplasms/drug therapy
- Skull Neoplasms/pathology
- Skull Neoplasms/radiotherapy
- Skull Neoplasms/surgery
- Skull Neoplasms/therapy
- Survival Analysis
- Temporal Bone/pathology
- Treatment Outcome
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Affiliation(s)
- S Schmerber
- CHRU Grenoble, Service d'Oto-Rhino-Laryngologie, F-38043 Grenoble 09, France.
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47
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Raut VV, Walsh RM, Bath AP, Bance ML, Guha A, Tator CH, Rutka JA. Conservative management of vestibular schwannomas - second review of a prospective longitudinal study. ACTA ACUST UNITED AC 2004; 29:505-14. [PMID: 15373864 DOI: 10.1111/j.1365-2273.2004.00852.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vestibular schwannomas have been traditionally managed with microsurgical removal and in recent years, stereotactic radiotherapy. However, there is a group of patients in whom a conservative management approach might represent a desirable alternative. The aim of this study was to determine the natural history and outcome following the conservative management of 72 patients with unilateral vestibular schwannomas. This is a prospective cohort review of a previously published group of patients [Clin. Otolaryngol. (2000) 25, 28-39] with unilateral vestibular schwannoma that were initially analysed at our institution in 1998 [Walsh R.M., Bath A.P., Bance M.L. et al., Clin. Otolaryngol. (2000) 25, 28]. The mean duration of follow-up was 80 months (range 52-242 months). All the patients in the study underwent serial magnetic resonance imaging (MRI) for assessment of tumour growth. Patients were deemed to have failed conservative management if there was evidence of rapid radiological tumour growth and/or increasing signs and symptoms, which necessitated active intervention. The mean tumour growth rate for the entire group at the second review was 1 mm/year (range -0.84-9.65 mm/year). The mean growth rate for cerebellopontine angle tumours (1.3 mm/year) was significantly greater than that of internal auditory canal (IAC) tumours (0 mm/year) (P = 0.005). The majority of tumours (87.14%) grew <2 mm/year. There was significant tumour growth seen in 38.9%, no or insignificant growth in 41.7%, and negative growth in 19.4%. Twenty-three patients (32%) failed conservative management at the second review. There was no difference in the outcome of these failed patients in comparison with patients who underwent primary treatment without a period of conservative management. The mean growth rate of tumours in patients that failed conservative management (3.1 mm/year) was significantly greater than that in patients who did not fail (0.2 mm/year) (P < 0.001). No factors predictive of tumour growth or failure of conservative management were identified. Hearing deterioration with pure tone averages (0.5, 1, 2, 3 kHz) and speech discrimination scores occurred irrespective of tumour growth. This prospective study further emphasizes the role of conservative management in selected cases of vestibular schwannomas. Tumours in this study confined to the IAC typically demonstrated minimal or no growth on serial MRI scanning. Regular follow-up with interval scanning is mandatory in all patients.
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Affiliation(s)
- V V Raut
- Department of Otolaryngology, New Cross Hospital, Wolverhampton, UK
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48
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Ziyeh S, Maier W, Spreer J. [Characteristic findings in tumor of the endolymphatic sac]. ROFO-FORTSCHR RONTG 2004; 176:1514-5. [PMID: 15383989 DOI: 10.1055/s-2004-813409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- S Ziyeh
- Sektion Neuroradiologie, Neurozentrum, Universitätsklinikum Freiburg
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49
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Abstract
A 62-year-old female was admitted to our clinic in October 1999 with a 6-year history of hearing loss, tinnitus and otorrhea in the right ear. Physical examination showed a polypoid mass arising from the right middle ear and extending into the external auditory canal. Serohemorrhagic otorrhea was also observed. Serious hemorrhage occurred while taking a biopsy. The histopathologic diagnosis was a glomangioma. MRI demonstrated a hypervascular mass (10 x 15 mm(2)) completely filling the right middle ear. Preoperative embolization of the ascending pharyngeal artery was carried out. The tumor was completely resected via a transmastoid approach. No complications were observed postoperatively. At the most recent follow-up examination, 72 months after the operation, no sign of disease was present. The modified radical mastoidectomy approach used in this case proved to be a safe and efficacious method for removing the glomangioma.
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Affiliation(s)
- Yavuz Uyar
- Department of Otolaryngology--Head and Neck Surgery, School of Medicine, Selcuk University, Konya, Turkey
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50
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Wang PC, Tu TY, Liu KD. Cystic brain necrosis and temporal bone osteoradionecrosis after radiotherapy and surgery in a patient of ear carcinoma. J Chin Med Assoc 2004; 67:487-91. [PMID: 15617312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Brain cyst formation of temporal lobe induced by radionecrosis in ear carcinoma is rare. A 73-year-old man with basosquamous carcinoma of the left external ear canal received excision of tumor and postoperative radiation therapy in 1992. For osteonecrosis of the left temporal bone, a series treatment including oral and intravenous antibiotics and hyperbaric oxygen therapy was given in following years. Encephalomalasia of the left temporal lobe on brain computed tomography (CT) was noted in 1997. The patient suffered from headache, poor concentration, memory impairment, depressed mood, bad temper, and one 8 x 5 x 3.5 cm cystic lesion of the left temporal lobe with tempomandibular joint defect revealed by brain CT in 2001. Symptoms relieved after stereotactic aspiration of cystic fluid and external drainage (Omaya reservoir) insertion under magnetic resonance image by neurosurgeon. We report the progressive radionecrosis of temporal lobe and cyst formation, which caused the neuropsychological symptoms 10 years after radiotherapy.
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Affiliation(s)
- Pei-Chung Wang
- Department of Otolaryngology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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