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Cases of Bilateral Temporal Bone Carcinomas Identified in the Literature (Staging of Tumors Based on Information Given in Case Reports and According to the Revised Pittsburgh Classification)
Source publication
We report a case of bilateral squamous cell carcinoma of the temporal bones in a 66-year-old woman who underwent a left subtotal petrosectomy and a right lateral temporal bone resection. Hearing rehabilitation was successfully achieved by fitting a bone-anchored hearing aid (BAHA) on the right side. We feel that in cases where the extent of the tum...
Similar publications
Objective: Osseointegrated hearing implants have been readily available and extensively used in developed countries for over twenty years. Despite a great need for this technology, use of these implants in developing countries has been limited due to the prohibitive cost of the surgical implant system as well as the implant devices themselves. To a...
Citations
... Because it is a death associated with an accidental event, a medical-legal autopsy is performed, where an elderly woman of medium size, mixed race is found; What is relevant to the post-mortem examination is scalp necrosis (Figure 1 It is determined that the cause of death is the accidental one due to acute meningitis derived from a craniocerebral trauma due to the fall of its own height. Revised the literature regarding this type of cancer is the most frequent type worldwide [1], in the head mainly affects the temporal bone, the oral cavity and the maxilla [2][3][4]. ...
... Squamous cell carcinomas (SCC) of the temporal bone are rare lesions, with annual diagnosis of one to five per 1 million people in United States [1,2]. First description of temporal bone SCC was provided by Schwartze and Wilde in the 18th century [3]. ...
Introduction:
Squamous cell carcinoma (SCC) of the temporal bone is a rare malignancy. Clear cell SCC is a rare variant of SCC of temporal bone in which no clear risk factor has been suggested as possible etiology. Otalgia, otorrhea, and hearing loss are the usual presenting symptoms of SCC of the temporal bone.
Presentation of case:
This is a case is of a 62-year-old female who presented with a 6 months' history of experiencing intermittent left hearing disturbance, loss of balance, persistent left tinnitus, left otalgia radiating to the lateral neck and post auricular swelling. Histology showed clear cell variant, well differentiated SCC. The patient's tumor was found to be non-resectable due to the extensive invasion. The patient was referred for palliative therapy by medical and radiation oncology, however, the patient couldn't tolerate it. One month later she passed away.
Discussion:
SCC of the temporal bone is a challenging clinical entity. It is diagnosed mainly by clinical and radiological assessment, and deep biopsies are used to confirm the diagnosis. Temporal bone SCC is usually diagnosed late due to delayed presentation. This case of temporal bone SCC was aggressive in nature and presentation. The presentation was different from the known triad of symptoms of temporal bone SCC which is offensive otorrhea, pain, and bleeding.
Conclusion:
This case showed a very destructive and bizarre clinical presentation but more report of cases is needed to have a better characterization of the clinical presentation and prognosis of this variant of SCC of temporal bone.
... Bilateral presentation of SCC in the external ear canal is an exceedingly rare presentation and a handful of them have been reported till date in literature. To the best of our knowledge, this is the 11 th case of SCC of bilateral temporal bones in literature [5,6]. ...
Squamous cell carcinoma of temporal bone is a rare entity, comprising of a very small percentage of all head neck tumours, mostly occurring in
aged population. Bilateral presentation of tumours in both temporal bones is extremely rare and only a few cases have been reported. We report a case
of bilateral squamous cell carcinoma of both temporal bones in a young adult male patient who presented very late.
Objective
Temporal bone squamous cell carcinoma (TBSCC) is rare and often confers a poor prognosis. The aim of this study was to synthesize survival and recurrence outcomes data reported in the literature for patients who underwent temporal bone resection (TBR) for curative management of TBSCC. We considered TBSCC listed as originating from multiple subsites, including the external ear, parotid, and external auditory canal (EAC), or nonspecifically from the temporal bone.
Data Sources
PubMed, Cochrane Library, Embase, and manual search of bibliographies.
Review Method
A systematic literature review conducted in December 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
Survival data were collected from 51 retrospective studies, resulting in a pooled cohort of 501 patients with TBSCC. Compared to patients undergoing lateral TBR (LTBR), patients undergoing subtotal (SBTR) or total (TTBR) TBR exhibited significantly higher rates of stage IV disease ( P < .001), positive surgical margins ( P < .001), facial nerve involvement ( P < .001), and recurrent disease ( P < .001). A meta-analysis of 15 studies revealed a statistically significant 97% increase in mortality in patients who underwent STBR or TTBR. On multivariate analysis, recurrent disease was independently associated with worse overall survival ( P < .001). On univariate analysis, facial nerve involvement was also associated with decreased overall survival ( P < .001).
Conclusion
Recurrent disease was associated with risk of death in patients undergoing TBR. Larger prospective multi-institutional studies are needed to ascertain prognostic factors for a wider array of postoperative outcomes, including histology-specific survival and recurrence outcomes.
Objective:
The use of microvascular free tissue transfer (MVFTT) for defects of the scalp and lateral temporal bone in patients with cochlear implants (CI) is uncommon. Herein, we report our experience with the utility, indications, and outcomes for MVFTT in patients with cochlear implants.
Methods:
A retrospective review of patients at our institution from September 2016 to December 2017 identified subjects with coexistent cochlear implant and ipsilateral MVFTT of the lateral temporal bone or scalp. Information including demographics, indication for MVFTT, timing of CI and MVFTT, donor site, and previous radiation to the head and neck was collected. To assess the current literature on MVFTT in CI patients, a MEDLINE search was performed using key search terms.
Results:
Two patients with cochlear implants and MVFTT of the ipsilateral temporal bone or scalp were identified. One patient underwent MVFTT for advanced device extrusion with stable audiometric parameters rather than locoregional reconstruction or device explantation. The second patient had primary cochlear implantation at oncologic lateral temporal bone resection (LTBR) and MVFTT for locally advanced squamous cell carcinoma and concurrent profound sensorineural hearing loss (SNHL). A literature review identifies MVFTT as an option for advanced device extrusion, treatment of osteoradionecrosis, and reconstruction after primary oncologic surgery.
Conclusion:
MVFTT is an important reconstructive tool for patients with functional, exposed cochlear implants. Cochlear implantation for severe to profound SNHL should be considered at the time of primary oncologic surgery and MVFTT of the lateral temporal bone or scalp.
Level of evidence:
IV Laryngoscope, 2019.
Implantable auditory devices (IADs) are a viable hearing restoration option for patients with hearing loss. Conditions such as chronic otitis externa, congenital aural atresia, and chronic otitis media can be treated with a variety of implants. Progressive disease are also amenable to restoration with IADs, providing stabilized hearing. When considering the best rehabilitative options, the patient's preference, ease of surgery, ease of device use, quality of life, and the traditional alternatives (such as ossiculoplasty, hearing aids, and cochlear implants) need to be considered. Patients with conductive, mixed, and sensorineural losses, mild to severe in nature, can be candidates for IADs.
Squamous cell carcinoma is the most common malignant tumor of the ear canal, middle ear, and temporal bone. That said, temporal bone cancer is rare, affecting only 1–2 persons/million population/year. Hearing loss, otalgia, and otorrhea are the classic triad of symptoms, but this triad is seen in only 10% of cases. Given its rarity, squamous cell carcinoma of the ear canal is often mistaken for otitis externa or media until biopsy is performed, confirming the diagnosis. Cross-sectional imaging, either CT, MRI, or both, is required to evaluate the extent of disease. The Pittsburgh staging system is used, and it is a reliable predictor of survival. Surgery is the primary treatment for these tumors, especially for early-stage disease. Postoperative radiotherapy is indicated for tumors staged T2 and higher, recurrent lesions, and for patients with positive margins, perineural and bone invasion, and lymph node metastasis. Preoperative chemotherapy and radiotherapy (CRT) has an emerging role for late-stage (T3 and T4) disease.
Malignant tumors involving the temporal bone are rare, aggressive tumors, which carry substantial risks for morbidity and mortality. The annual incidence of primary cancer of the temporal bone is one to six cases per 1,000,000; males and females are equally inflicted. Common ages at presentation span the fifth and sixth decades. Diagnosis of patients with temporal bone cancers (TBCs) is often delayed, as early symptoms are often ascribed to the much more common otitis media or externa [1]. This delay is likely to have a detrimental effect on treatment and outcome.
Malignant tumours of the temporal bone are rare, aggressive tumours, which carry substantial risks for morbidity and mortality. Diagnosis of patients with temporal bone cancers (TBCs) is often delayed, as early symptoms often imitate similar and more common conditions such as otitis externa and aural polyps. This delay is likely to have a detrimental effect on treatment and outcome. If symptoms persist or signs are compatible with a malignancy, a high index of suspicion for cancer must be maintained.
Squamous cell carcinoma of the temporal bone is a rare entity. Only a few cases have been reported in the literature and even fewer describe bilateral tumours. Because its clinical presentation resembles chronic otitis media or otitis externa, diagnosis could be delayed.
A case is presented of bilateral squamous cell carcinoma of the temporal bone in a 66 year old woman. The patient underwent a left subtotal petrosectomy followed by a right subtotal petrosectomy a month later.
Early diagnosis is directly related to patient prognosis. However, prognosis remains poor and the surgical treatment is a challenge for the experienced skull base surgeon.
