Poorly Differentiated Primary Carcinoma of the Middle Ear on 18F-FDG PET/CT.

Primary carcinoma of the middle ear is extremely rare. A 41-year-old woman with a history of skull base osteomyelitis and chronic suppurative right otitis media presented with 1 month of right-sided facial droop, tearing, and headaches. Initial head CT revealed bony destruction and soft tissue opacification involving the right middle ear. Surgical biopsy yielded poorly differentiated carcinoma. Subsequent F-FDG PET/CT and MRI scans demonstrated FDG-avid soft tissue in the right middle ear with associated heterogeneously enhancing soft tissue on MRI.