Patterns of involvement of the temporal bone in metastatic and systemic malignancy

Abstract

The temporal bone appears to be involved with secondary malignant processes in discrete histologic patterns with rather characteristic clinical presentations. Five distinct types of involvement can be recognized: isolated metastasis from a distant primary tumor; direct extension from a regional primary tumor; meningeal carcinomatosis; leptomeningeal extension from an intracranial primary tumor; and leukemic or lymphomatous infiltration. The typical histopathological patterns are described with correlative clinical symtomatology. Differential diagnosis is considered, and guidelines for surgical management are discussed.

Metastases to the Head and Neck: An Overview

“…Berlinger et al [7] indicate that the temporal bone may be involved with secondary malignant neoplasms by five distinct pathways: (1) isolated metastasis from a distant primary tumor, (2) direct extension from a regional primary tumor, (3) meningeal carcinomatosis, (4) leptomeningeal extension from an intracranial primary tumor, and (5) leukemia or lymphomatous infiltration. Most metastases (75%), however, are hematogenous and involve the first pathway as noted above [8].…”

Temporal bone involvement by prostatic adenocarcinoma: Report of two cases and review of the literature

“…12 The middle ear and hence the temporal bone could conceivably be involved by any tumor that has spread to the cervical nodes, The setting for this type of metastasis would typically be widespread tumor. However, isolated temporal bone metastasis is thought to represent hematogenous spread, since the sluggish blood flow in the bone-marrow-containing areas of the temporal bone (petrous portion) would provide a suitable environment for the deposit of tumor cells.…”

Poorly Differentiated Fibrosarcoma (Spindle Cell Sarcoma) Involving the Temporal Bone

“…Berlinger et al [6] classified the patterns of the involvement of the temporal bone in metastatic tumors into five types: isolated metastasis from a distant primary tumor, di rect extension from a regional primary tu mor, meningeal carcinomatosis, leptomeningeal extension from an intracranial primary tumor, and leukemic or lymphomatous infil tration. Also, Adams et al [7] described in his 30 cases that there were 10 cases which were secondarily affected by distant primary and 4 cases which were invaded by direct extension from head and neck primaries, and that all 4 cases were carcinoma which had tumor involvement of the petrous por tion and base of the skull like our present case.…”