[Carcinoma of the temporal bone--current diagnostic and therapeutic aspects].

BACKGROUND

Carcinoma of the external ear canal and the middle ear is a rather rare event and is especially seen in patients with chronic inflammatory ear disease.

PATIENTS: Between 1993 and 1994, we treated seven patients with such a tumor, of which six proved to be a squamous cell carcinoma and one presumably adenocarcinoma. In three patients, the malignoma developed in a radical cavity of the ear and caused a facial palsy. Only two patients were without any discharge of the ear. Beside facial palsy, hemorrhagic otorrhea and otalgia were the leading symptoms. One patient presented with a bilateral painless swelling of the neck due to lymph node metastasis. Diagnosis was made by means of biopsy in only three patients and on the basis of a resected specimen after mastoidectomy in four patients. Angiography and computed tomography and magnetic resonance imaging studies were performed prior to treatment to determine the extent of the tumor.

RESULTS

The tumor was resected by petrosectomy, parotidectomy, and neck dissection in 5 patients. Three times the margins of the histological specimen were free of tumor. Lymph node metastasis in the neck were seen in 5 cases, while distant metastasis did not occur. Two patients underwent primary irradiation, but a postoperative radiation therapy was performed five times. To date, three patients died after one year follow-up.

CONCLUSIONS

Carcinoma of the temporal bone is a rare tumor, which can be treated only in case of early diagnosis.