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 »  Abstract
 »  Introduction
 »  Case Report
 »  Discussion
 »  References

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SHORT REPORTS
Year : 2003  |  Volume : 51  |  Issue : 3  |  Page : 416-417

Temporal bone carcinoma with intradural extension


Neurosurgery Unit, R. G. Kar Medical College, 1, Kshuiram Bose Rarani, Kolkata - 700004

Correspondence Address:
Block-B, 148, Bangur Avenue, Kolkata - 700055
dibyendukroy@yahoo.com

  »  Abstract

A case of temporal bone carcinoma having intradural extension is reported. To the best of our knowledge, no such case has been reported so far.

How to cite this article:
Khan A K, Deb S, Ray D K. Temporal bone carcinoma with intradural extension . Neurol India 2003;51:416-7


How to cite this URL:
Khan A K, Deb S, Ray D K. Temporal bone carcinoma with intradural extension . Neurol India [serial online] 2003 [cited 2019 Dec 15];51:416-7. Available from: http://www.neurologyindia.com/text.asp?2003/51/3/416/1194


   »   Introduction Top

Temporal bone squamous cell carcinoma originates most frequently in the external auditory meatus and then extends into the middle ear and mastoid air cells.[1] We report a case of temporal bone carcinoma having an intradural extension.

   »   Case Report Top

A 27-year-old male patient had a long-standing purulent left ear discharge. For one year the purulent discharge had become blood-stained. For one month he had headaches and vomiting, intense pain in the left ear, a fungating mass in the retro-auricular region and dribbling of saliva from the left corner of the mouth. On examination, a fleshy pinkish-red, friable polypoidal mass was seen filling the left external auditory canal. The mass measured about 5 cm x 5 cm and bled on touch. The underlying bone at the mar­gin of the growth was eroded. Lower motor neuron type of facial palsy was present on the left side. There was no enlargement of the cervical lymph nodes.
Audiometry revealed both conductive and sensorineural deafness in the left ear. Plain skiagram of the left mastoid showed bony erosion. A computerized tomographic (CT) scan of the head showed an irregularly enhancing lesion eroding the left petrous bone producing a scalp swelling in the left temporal region. The lesion extended intradurally in the posterior temporal region. The tumor enhanced on contrast administration, had extensive perilesional edema and resulted in mass effect [Figure - 1]. Histopathological examination (HPE) of the biopsy taken from the tumor mass protruding out of the external ear canal revealed a squamous cell carcinoma. The patient was operated by a retro-mastoid incision and a radical resection of the middle ear, temporal bone and the intradural portion of the tumor, was achieved. The tympanic membrane and the ossicles could not be identified. The dura of the posterior fossa was not involved. The postoperative course was uneventful.
HPE showed epithelial pearls along with inva­sive strands of cells characteristic of well-differentiated squamous cell carcinoma [Figure - 2]. Sec­tions from the skin overlying the tumor did not show any such involvement.

   »   Discussion Top

The dura, like connective tissue elsewhere, constitutes at least a mechanical barrier against infection.[2] There probably also exists a biological resistance of the dura to neoplastic infiltrations.[3] Rare reports of the breach of such resistance exist for glioblastomas[4] and gliosarcomas.[5] Though spread of squamous carcinoma of the ear to the outer layer of dura has been reported,[6] we failed to come across any report of dural penetration of such tumors with subsequent intradural growth.
 

  »   References Top

1.Cheesman AD. Tumours of the middle ear and mastoid. In: Ludman H, editor. Mawson's Diseases of the Ear. 5th edn. London: Edward Arnold; 1988. pp. 556-9.  Back to cited text no. 1    
2.Williams PL, Warwick R, Dyson M, Bannister LH. Gray's Anatomy. 37th edn. Edinburgh: Churchill Livingstone; 1987.  Back to cited text no. 2    
3.Aoyama I, Makita Y, Nabeshima S, Motomochi M, Masuda A. Extradural nasal and orbital extension of glioblastoma multiforme without previous surgical intervention. Surg Neurol 1980;14:343-7.  Back to cited text no. 3  [PUBMED]  
4.Michaels L, Wells M. Squamous cell carcinoma of the middle ear. Clin Otolaryngol 1980;5:235-48.  Back to cited text no. 4  [PUBMED]  
5.Shuangshoti S, Kasantikul V, Suwnwela N. Spontaneous penetration of dura mater and bone by glioblastoma multiforme. J Surg Oncol 1987;36:  Back to cited text no. 5    
6.36-44.  Back to cited text no. 6    
7.Morantz RA, Feigin I, Ransohoff J. Gliosarcoma: A clinical and pathological survey of 24 cases. J Neurosurg 1976;45:398-406.  Back to cited text no. 7    

 

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