Primary tumors and tumor-like lesions of the eustachian tube: a systematic review of an emerging entity

Abstract

Eustachian tube (ET) primary tumors and tumor-like lesions are rare diseases presenting with common ear, nose and throat symptoms. Pathology can range from developmental anomalies to high malignant neoplasms. Hence this review aimed at suggesting a classification and outline relevant aspects of ET primary tumors and tumor-like lesions, describing clinical findings, diagnostic management and therapeutic approaches. MEDLINE, CINAHL, OVIDSP, HIGHWIRE, and GOOGLE databases were searched from inception to July 2011 for relevant studies. Further papers were identified by examining the reference lists of all included. Sixty-five papers met the inclusion criteria, enclosing 78 cases. Case reports are increasing in the past few years. Benign lesions and tumor-like lesions of ET have been reported. Moreover, melanomas, carcinomas, and sarcomas can affect the ET as a primary site.

Primary tuberculosis of the eustachian tube causing otitis media with effusion

“…Although specific literature on ET imaging is lacking, it is well known that CT is the most reliable imaging tool for the evaluation of middle ear, temporal bone, and bony portion of ET [1]. Magnetic resonance imaging (MRI) is superior to CT for displaying soft tissues and for differentiating tumors form normal tissues [1]. In the present case, CT image showed asymmetric mucosal thickening and enhancement of the left Rosenmuller's fossa.…”

“…However, the diagnosis of ET tuberculosis cannot be made solely on the basis of a nasopharyngeal examination. Although specific literature on ET imaging is lacking, it is well known that CT is the most reliable imaging tool for the evaluation of middle ear, temporal bone, and bony portion of ET [1]. Magnetic resonance imaging (MRI) is superior to CT for displaying soft tissues and for differentiating tumors form normal tissues [1].…”

“…Primary ET tuberculosis is defined as an isolated tuberculosis infection of the ET in the absence of pulmonary tuberculosis and usually occurs in countries in which tuberculosis is endemic [1], although ET tuberculosis may be associated with pulmonary or lymph node tuberculosis. In this case, Korea is an endemic area of the tuberculosis and the patient had no active lesion on the chest radiography, suggesting primary ET tuberculosis.…”

“…Therefore, ET may be deeply associated with otologic and rhinologic symptoms. It is well known that ET dysfunction or occlusion is an important factor leading to otitis media with effusion (OME) [1]. Although ET dysfunction may be triggered by many causes, including viral infection, chronic sinusitis, allergic rhinitis, adenoid hypertrophy, and cleft palate [2], mechanical obstruction of the ET should be considered.…”

Osseous Hamartoma Arising from the Eustachian Tube

“…Tumors and tumor-like lesions of the Eustachian tube (ET) are rare, and Muzzi et al 1 have reviewed 78 cases that were reported between 1988 and 2011. The pathology of ET tumors varies, and more than five reports each have described for teratoma, 2 dermoid tumors, 3 melanin-pigmented oncocytic metaplasia, 4 and chondroma 5 as benign tumors and also melanoma, 6 squamous and/or transitional cell carcinoma 7,8 as malignant tumors.…”