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Squamous cell
carcinoma of the temporal bone: a radiographic -pathologic
correlation. Arch Otolaryngol Head Neck Surg.2001 Jul;127(7):803-7.
OBJECTIVE:
To assess the utility of a previously proposed staging system for
patients with primary squamous cell carcinoma of the temporal bone.
METHODS: Retrospective chart review of 15 patients treated for
squamous cell carcinoma of the temporal bone over a 13-year period
at an academic tertiary referral center. A review of the medical and
surgical records, radiographic studies, and surgical pathology
reports allowed for an evaluation of the University of Pittsburgh
staging system. Outcome analysis was performed on 13 patients with
more than 24 months of follow-up. RESULTS: Radiographic and surgical
pathology staging according to the University of Pittsburgh staging
system correlated in 11 (73%) of 15 cases. The radiographic staging
system was more accurate for larger (T3/T4) tumors than for smaller
(T1/T2) tumors (83% vs 67%). When compared with patients with no
evidence of disease, nonsurvivors were more likely to present with
otalgia (67% vs 43%), facial nerve paralysis (33% vs 0%), and T3/T4
tumors (100% vs 14%). CONCLUSIONS: Pathologic staging by the
University of Pittsburgh staging system closely correlates with
patient outcome and is more sensitive than preoperative radiographic
staging. Prognosis in squamous cell carcinoma of the temporal bone
is largely determined by the extent of local disease at the time of
presentation.
Squamous cell
carcinoma of the temporal bone arising 43 years after fenestration
procedure. Am J Otol.1993 Sep;14(5):512-4.
Squamous
cell carcinoma originating in the middle ear cleft is a rare tumor
that tends to be diagnosed late in its course. The presenting
symptoms mimic inflammatory disease of the middle ear space, and
hence biopsy is often delayed. Herein we present a case of squamous
cell carcinoma of the temporal bone arising 43 years after
fenestration procedure. Operative findings were significant for
complete dissolution of the tegmen tympani, tegmen mastoideum, and
posterior fossa dura plate with dural exposure and sigmoid sinus
exposure. Tumor was noted to invade the labyrinth at the horizontal
semicircular canal. This case report highlights the aggressiveness
of this particular tumor in a previously exenterated mastoid cavity
and its proclivity to penetrate the otic capsule via pre-formed
pathways. The treatment of choice is aggressive surgical resection
followed by radiotherapy.
Squamous cell
carcinoma of the middle ear. A 25-year retrospective study. Ann Otol
Rhinol Laryngol.1985 May-Jun;94(3):273-7.
Squamous
cell carcinomas of the middle ear cleft are highly unpleasant tumors
which pose many problems for the otologist. We have retrospectively
reviewed the hospital notes of 21 patients (22 ears) who presented
with this disease in order to try to clarify those features which
are of prognostic significance. We confirmed that a history of
chronic suppuration with or without cholesteatoma predisposes the
patient to tumor development and that, in the presence of continuing
otorrhea, patients are not protected by mastoid surgery. These
patients have been treated with conservative surgery and
radiotherapy without en bloc resection of the temporal bone and, in
these circumstances, the histological grade of the tumor at
presentation appears to bear a direct relationship to survival.
Primary squamous
cell carcinoma of the middle ear invading the cochlea. A
histopathological case report. Ann Otol Rhinol Laryngol.1983
May-Jun;92(3 Pt 1):290-4.
This report
describes the histopathological changes in the temporal bone of a
71-year-old man who died of meningitis and epidural abscess
complicated by primary squamous cell carcinoma of the middle ear.
The present case is unusual and differs somewhat from previously
reported cases of the primary squamous cell carcinoma of the middle
ear in three respects: 1) an extensive invasion of the cancer into
the membranous labyrinth, 2) cholesterol deposits in the cochlear
spiral canal, and 3) presence of ossifying labyrinthitis. Among
these findings, extensive involvement of the inner ear by cancer
destroying the lower part of the otic capsule is particularly
unusual. It is assumed that squamous cell carcinoma overcame the
biological resistance to neoplastic infiltration which probably
exists in the otic capsule and the membranous labyrinth.
Squamous cell
carcinoma of the middle ear. Clin Otolaryngol Allied Sci.1980
Aug;5(4):235-48.
The clinic
features of 28 cases of squamous cell carcinoma of the middle ear
are reviewed. Only one patient developed cervical lymph node
metastasis and one radiological evidence of pulmonary metastasis.
Fourteen of 23 patients (61%) died within 5 years after treatment
from intracranial extension of the neoplasm. The pathological
findings in three cases in which serially sectioned temporal bones
were available are described. An important feature in each case was
a penetration by tumour of the bony wall on the medial wall of the
middle ear to infiltrate the carotid canal and b penetration by
tumour of the thin layer of bone between the posterior mastoid air
cells and the dura with subsequent invasion along the dura and into
the internal auditory meatus. In one case the cochlea was
infiltrated from the latter situation, but direct invasion of the
cochlea from the middle ear was not observed. In view of the
extensive infiltration that is probably already present at the time
of diagnosis, radical surgical procedures are contraindicated.
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