Clinical Characteristics and Management of External Auditory Canal Squamous Cell Carcinoma in Post-Irradiated Nasopharyngeal Carcinoma Patients

Wang, Jing; Xie, Bingbin; Dai, Chenyang

doi:10.1097/mao.0000000000000739

Cited by 10 publications

(15 citation statements)

References 30 publications

(17 reference statements)

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“…The post-irradiated EAC SCC shows no special symptoms compared with its primary counter part. Our patient complained a progressive hearing loss with a repeated purulent ear discharging over 6 months with a latency period of 6 years from the first cure of RT, which is much lower than the period reported in others studies [5,25]. Wang et al [25] reported in his study including 9 irradiated NPC patients among a total of 50 patients, that the proportion of early stage cases in the post-irradiated EAC SCC patients was higher than that in the primary EAC SCC patients.…”

Section: Discussionmentioning

confidence: 48%

“…Our patient complained a progressive hearing loss with a repeated purulent ear discharging over 6 months with a latency period of 6 years from the first cure of RT, which is much lower than the period reported in others studies [5,25]. Wang et al [25] reported in his study including 9 irradiated NPC patients among a total of 50 patients, that the proportion of early stage cases in the post-irradiated EAC SCC patients was higher than that in the primary EAC SCC patients. He explained by the non specific symptomatology of the early stage of EAC SCC so that early diagnosis of primary EAC SCC is difficult to achieve and the fact that post-irradiated patients are more aware of lesion sin the irradiation field so they may seek evaluation by physicians as soon as possible (Not clear, rewrite it).…”

Section: Discussionmentioning

confidence: 48%

“…The post-irradiated EAC carcinoma has been infrequently reported [18][19][20][21][22][23][24][25]. Lo et al [5] reported that the incidence of EAC carcinoma in the post-irradiated NPC population was 1000 times greater than the reported incidence of primary EAC carcinoma in the general population.…”

Section: Discussionmentioning

confidence: 89%

“…A retrospective review including 144 patients did not find evidence of improved survival with the addition of RT to TBR (with 48 vs. 44.4% 5-year survival for TBR + RT vs. TBR alone, respectively) [34]. Wang [25] reported that Adjuvant postoperative RT was not significantly correlated with the overall survival rates but it is unnecessary for early stage EAC SCC, particularly in patients with guaranteed intraoperative tumor-free margins. Our patient has undergone a postoperative RT given the affected resection margins despite the extensive surgical treatment that was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Ogawa et al [14] According to Wang [25], the post irradiated EAC SCC patients had received RT for NPC previously, and adjuvant postoperative RT may induce serious complications even over the long term after the first radiotherapy. In his study, 5/9 post-irradiated EAC SCC patients received another course of adjuvant RT and three of them developed severe radionecrosis.…”

Section: Discussionmentioning

confidence: 99%

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Hearing Loss Revealing a Squamous Cell Carcinoma of External Auditory Canal in a Post-Irradiated Patient for Nasopharyngeal Carcinoma

Chafiki¹

2017

MOJBM

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Background: Primary Carcinoma of external auditory canal (EAC) is a rare disease accounting for less than 2% of head and neck cancers and has an annual incidence of around 1 per million populations. EAC carcinoma in postirradiated nasopharyngeal carcinoma (NPC) patients occurs with an incidence of approximately 0.15%. It arises from the external ear and spreads to the temporal bone and surrounding sites. Although its rarity, it is a life threatening disease with practically a poor constant prognosis. Primary EAC carcinoma can occur with no specific symptoms. Aggressive surgery with postoperative radiation remains the usual treatment until now. We report a rare case of a squamous cell carcinoma (SCC) of EAC revealed by a progressive hearing loss as first presentation of the disease in a post-irradiated woman for NPC. Results:A 47-year-old female with a past medical history of nasopharyngeal carcinoma treated with chemo radiation therapy, presented for repeated leftsided purulent ear discharge and progressive hearing loss. Otoscopic examination revealed a tissue mass filling the left EAC. CT scan revealed a soft tissue density process filling the EAC, encroaching upon the tympanic cavity and coming into contact with the handle of the malleus neither with no acicular lyses nor EAC walls erosion. The biopsy of the mass was consistent with EAC SCC. The patient under went lateral temporal bone resection with homolateral superficial parotidectomy and selective neck dissection and completed by an adjuvant external radiation therapy [RT]. Conclusion:Post-irradiation EAC SCC has similar symptoms and invades similar regions as its primary counterpart. This entity is usually discovered in the early stage in post-irradiated EAC SCC patients comparing to the primary EAC SCC. Aggressive surgical treatment is strongly recommended, but adjuvant radiotherapy for early stage EAC SCC should be provided cautiously to prevent further radiation induced complications.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hearing Loss Revealing a Squamous Cell Carcinoma of External Auditory Canal in a Post-Irradiated Patient for Nasopharyngeal Carcinoma

Chafiki¹

2017

MOJBM

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Expression profiling of long noncoding RNA identifies lnc‐MMP3‐1 as a prognostic biomarker in external auditory canal squamous cell carcinoma

Liu

Dai

et al. 2017

Cancer Medicine

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Our previous studies suggested external auditory canal squamous cell carcinoma (EACSCC) is a rare malignancy with heterogeneous outcomes. This study aimed to identify lncRNA profile of EACSCC and determine the clinical application. Differential expression genes (DEGs) were investigated in EACSCC by whole transcriptome lncRNA arrays (GPL23178). RT‐PCR was used to quantify the microarray data. Bioinformatics analyses were performed to evaluate DEGs regulations in gene ontology and cellular pathways. Fluorescence in situ hybridization (FISH) was utilized to validate lncRNA expression. The overall survival was determined by Kaplan–Meier and log‐rank analyses. Our microarrays data had been submitted to Gene Expression Omnibus (GSE98912). We identified 5621 DEGs (3185 mRNAs, 2436 lncRNAs) in EACSCC. Lnc‐MMP3‐1 was the top one upregulated lncRNA in EACSCC with fold change of 237.2 (P < 0.001). RT‐PCR results showed similar expression levels as microarrays data. Bioinformatics analyses indicated development of EACSCC was involved in aberrant alternations of multiple biological processes and cellular pathways. FSIH assays also found lnc‐MMP3‐1 was significantly differentially overexpressed in EACSCC (P < 0.001). Tumor lnc‐MMP3‐1 levels were closely associated with differentiation degree (P = 0.016), tumor invasion (P = 0.015) and TNM stage (P = 0.015). Moreover, lnc‐MMP3‐1 expression was a significant prognostic factor in EACSCC (χ 2 = 4.276, P = 0.039). The study is the first screening and analysis of lncRNAs profile in EACSCC and provides new insights into pathogenesis of this rare disease. Our findings offered convincing evidences that lnc‐MMP3‐1 is a novel survival predictor of EACSCC patients.

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Right dominance in the incidence of external auditory canal squamous cell carcinoma in the Japanese population: Does handedness affect carcinogenesis?

Tsunoda

Sumi

Terasaki³

et al. 2017

Laryngoscope Investig Oto

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Objectives/HypothesisTo investigate the relationship between handedness and the incidence of squamous cell carcinoma in the external auditory canal (EACSCC).Materials and MethodsSixty‐eight cases of EACSCC were enrolled in this study, and their affected side was checked. Handedness and ear‐picking habits were also investigated in 34 EACSCC cases. Handedness was judged based on self‐categorization, and the relationship between handedness and the affected side was investigated.ResultsFifty‐two cases occurred on the right side, and 16 cases occurred on the left side of patients with EACSCC. The incidence of laterality in EACSCC showed a statistically significant right dominance. Concerning handedness, 29 cases were right‐handed, 4 cases were left‐handed, and 1 case was ambidextrous. Twenty‐seven out of the 29 right‐handed cases and 1 ambidextrous case suffered from carcinoma on the right side, whereas 3 left‐handed cases suffered from carcinoma on the left side. That is, most of the cases suffered from EACSCC on the same side as their handedness, and this tendency showed a statistically significant difference. Most of the patients with EACSCC experienced itching and habitual ear‐picking in the affected side.ConclusionMechanical stimulations to the EAC, such as ear picking, may plausibly cause EACSCC. In Japan, ear picking, also called “mimikaki,” is a popular habit and an established unique culture. Because ear picking requires delicate handling and manipulation, this tends to occur on the same side as the handedness in the Japanese population. This is the first report about the relationship between handedness and carcinogenesis.Level of EvidenceN/A.

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Clinical Characteristics and Management of External Auditory Canal Squamous Cell Carcinoma in Post-Irradiated Nasopharyngeal Carcinoma Patients

Cited by 10 publications

References 30 publications

Hearing Loss Revealing a Squamous Cell Carcinoma of External Auditory Canal in a Post-Irradiated Patient for Nasopharyngeal Carcinoma

Hearing Loss Revealing a Squamous Cell Carcinoma of External Auditory Canal in a Post-Irradiated Patient for Nasopharyngeal Carcinoma

Expression profiling of long noncoding RNA identifies lnc‐MMP3‐1 as a prognostic biomarker in external auditory canal squamous cell carcinoma

Right dominance in the incidence of external auditory canal squamous cell carcinoma in the Japanese population: Does handedness affect carcinogenesis?

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