A 54-year-old woman with no significant medical history or otologic pathology presented to our center with a unilateral progressive right hearing loss, aural fullness, and tinnitus. Otoscopy showed a yellow retrotympanic mass with an intact membrane. Audiometry showed a slight conductive hearing loss. Computed tomography and magnetic resonance imaging revealed a soft tissue mass occupying the middle ear without destruction of the ossicular chain or other bone involvement.The patient underwent excision of the mass through a transcanal approach with conservation of the ossicular chain. Follow-up at 24 months showed improved hearing and no evidence of recurrence.Histological examination demonstrated cubical cells, with small regular nuclei, dense chromatin, eosinophilic cytoplasm, in a nestlike architecture and collagen stroma, with occasional gland lumina formation. No atypical cells were seen (Fig. 1A).Inmunohistochemistry was positive for synaptophysin and cytokeratin, confirming the diagnosis of adenoma of the middle ear with neuroendocrine differentiation (Fig. 1B).
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