Metastatic Disease of the Temporal Bone: A Contemporary Review

Abstract

Objectives To identify the frequency and primary site of metastatic pathologies to the temporal bone and characterize the associated symptomatology. Methods The MEDLINE, Embase, and Web of Science databases were systematically reviewed according to the PRISMA guidelines to identify all cases of pathologically confirmed distant temporal bone metastases published with English translation until October 2019. Descriptive statistics were performed. Results Out of 576 full‐length articles included for review, 109 met final criteria for data extraction providing 255 individual cases of distant temporal bone metastases. There was a male predominance (54.9%) with median age of 59.0 years (range 2–90). The most common locations of primary malignancy included the breasts (19.6%), lungs (16.1%), and prostate (8.6%). Most tumors were carcinomas of epithelial origin (75.3%) and predominantly adenocarcinoma (49.4%). The commonest metastatic sites encountered within the temporal bone were the petrous (72.0%) and mastoid (49.0%) portions. Bilateral temporal bone metastases occurred in 39.8% of patients. Patients were asymptomatic in 32.0% of cases. Symptomatic patients primarily reported hearing loss (44.3%), facial palsy (31.2%), and otalgia (16.6%) for a median duration of 1 month. Petrous lesions were associated with asymptomatic cases (P = .001) while mastoid lesions more often exhibited facial palsy (P = .026), otalgia (P < .001), and otorrhea (P < .001). Non‐carcinomatous tumors were associated with petrosal metastasis (P = .025) and asymptomatic cases (P = .109). Carcinomatous metastases more often presented with otalgia (P = .003). Conclusions Temporal bone metastasis is uncommon but should be considered in patients with subacute otologic symptoms or facial palsy and history of distant malignancy. Laryngoscope, 131:1101–1109, 2021

Incidental finding of metastatic prostatic adenocarcinoma of frontotemporal bone presenting as subdual hematoma: A case report and review of literature

“…A review of the literature shows that cases of bony metastatic cancer occurring in the skull and temporal bones are relatively rare [ [1] , [2] , [3] , 5 , 8 , 9 , 11 ]. The frequency and primary tumor site of temporal bone metastasis were determined, and the related symptoms were characterized.…”

“…The most common sites of primary malignant tumors included the breast (19.6%), lung (16.1%), and prostate (8.6%), which were predominantly adenocarcinomas in origin (49.4%). The most common sites of metastasis are the petrous bone (72.0%) and mastoid (49.0%) of the temporal bone, and patients with bilateral temporal bone metastasis accounted for 39.8% [ 5 ]. However, some cases have no obvious clinical symptoms, such as urological symptoms or cranial deficits, and the involvement of temporal mass has no specific clinical signs, such as atypical clinical symptoms in the present case.…”

“…Prostate cancer metastasis is frequently observed in the axial skeleton, and skull bone metastasis in prostatic adenocarcinoma (PCa) is extremely rare, accounting for less than 2% of all metastases. It often invades the base of the skull and has diverse clinical manifestations to preferentially cause urological symptoms or multiple cranial nerve palsies, otological symptoms, and ophthalmoplegia, especially bone pain or cranial deficits [ [1] , [2] , [3] , [4] , [5] ].…”

“…Previous reports have documented skull metastases from all types of primary cancers, the most common being breast, lung, prostate, and thyroid cancers [ 1 , 3 , 5 ]. As the treatment of patients with advanced bony tumors is more effective and the life expectancy is longer, an increasing number of imaging studies have found skull bone metastasis.…”

“…Most skull bone metastases are purely intraosseous lesions limited to the calvarium or base of the skull [ 6 ]. A review of previous reports and literature revealed that metastatic prostate cancer of the temporal bone is rare, especially in the frontotemporal bone [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ].…”