CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S197
DOI: 10.1055/s-0038-1640395
Poster
Otologie: Otology

Adenocarcinoma of the middle ear – a case report

E Jahns
1   Hals-Nasen- und Ohrenklinik, Universitätsklinikum, Marburg
,
R Weiß
2   Hals-Nasen- und Ohrenklinik, Universitätsklinikum Gießen und Marburg, Standort M, Marburg
,
B Stuck
2   Hals-Nasen- und Ohrenklinik, Universitätsklinikum Gießen und Marburg, Standort M, Marburg
,
M Schulze
3   Abteilung Neuroradiologie, Universitätsklinium Gießen und Marburg, Standort Marb, Marburg
,
S Kösling
4   Department für Strahlenmedizin Universitätsklinik und Poliklinik für Radiologie,, Halle/S.
,
S Plontke
5   Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf-und Hals-, Halle/S.
,
K Reimann
2   Hals-Nasen- und Ohrenklinik, Universitätsklinikum Gießen und Marburg, Standort M, Marburg
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    Carcinoma of the middle ear are a rare tumor entity. To date, adenocarcinoma of the middle ear have been only described as case reports in the literature. Besides as primary tumor manifestation, implantation metastasis of adenocarcinoma in the middle ear occur and have been described previously.

    Here we report about a 60 year old male patient, who underwent a transcranial tumor resection for a pT4N0M0 adenocarcinoma of the right ethmoid sinus infiltrating the scull base in early 2016. This was followed by adjuvant radiotherapy. 18 months later the patient presented with left-sided otorrhea, hearing loss and low grade facial paralysis. ENT examination revealed a tumor in the middle ear. Histological examination showed an adenocarcinoma consistent with a mucosal in-situ proliferation of the initial sinunasal adenocarcinoma. Local recurrence in the paranasal sinuses, the nasopharynx and eustachian tube could be excluded. We performed a tumor resection via petrosectomy. Here the main tumor was located mesotympanal, in the atrum and epitympanal with extensive dural infiltration in the tegmen tympani and mastoideum.

    Case reports describe two mechanisms for the development of adenocarcinoma in the middle ear. One is the formation as recurrent adenoma, the other describes the spread of tumor cells due to regular irrigation of the nostrils postoperatively in patients with adenocarcinoma of the paranasal sinuses. Both scenarios are not very likely in this case, although a link to the adenocarcinoma of the paranasal sinuses seems likely. Spread of tumor cells via the eustachian tube seems possible despite evidence for a tumor manifestation there.


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    No conflict of interest has been declared by the author(s).

    Evelyn Jahns
    Hals-Nasen- und Ohrenklinik, Universitätsklinikum,
    Baldinger Straße, 35043,
    Marburg

    Publication History

    Publication Date:
    18 April 2018 (online)

    © 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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