Squamous cell carcinoma of the mastoid – a report of two cases

Abstract

SUMMARYMalignant tumours of the mastoid are rare, the majority being squamous cell carcinomas. We report two cases whose clinical presentation mimicked mastoid abscess with intracranial complications. The first case is a twenty year Nigerian lady who presented to the Emergency Room of the Otorhinolaryngology Department with a one month history of headache, low grade fever, left facial palsy, neck stiffness and left post-auricular swelling on a background of left chronic suppurative otitis media since childhood. An initial diagnosis of meningitis and mastoid abscess secondary to chronic suppurative otitis media was made but histology of the mastoid specimen revealed keratinizing squamous cell carcinoma, which was treated with palliative primary radiotherapy. The second case is a 45-year old man with a chronic mastoiditis and mastoid abscess that was later found to be suamous cell carcinoma of the mastoid and was managed with combination of surgery and radiotherapy. The report highlights advanced stage of the disease at presentation, and discusses the etiology and management. To the best of our knowledge, these are the first cases of this entity to be documented in Africans.

Left Chronic Otitis Media with Squamous Cell Carcinoma of the Middle Ear and Postauricular Mastoid Fistula: A Case Report

“…1 Lasissi et al reported a case of recurrent left ear discharge, which worsened six months before presentation. 5 Though the history is quite close to our case the associated symptoms severe deep-seated left otalgia, left hemi-cranial headache, hearing loss, vertigo, and tinnitus, facial nerve palsy was absent in our case. Hu X-D reported a case with bloody discharge, painless skin ulceration in the mastoid area, where peripheral facial paralysis was seen, 1 but in our patient, we only had an ulcerated mastoid region with mastoid fistula.…”

Temporal bone carcinoma in a 25 year old patient

“…Middle ear carcinoma in a patient as young as 18 years has been reported by Deka RC whereas O.A Lasisi has reported a similar case in a 20 year old female. 4,5 Chronic otorrhoea, as seen in COM may be a major etiological factor. Presence of long standing COM with a recent change in the pattern of symptoms like obstinate otalgia is a pointer towards the unlikely disease.…”

Squamous cell carcinoma of tympanomastoid region - A rare and often misdiagnosed entity

“…The first case in Africa was reported in 2005 which highlights the dilemma of diagnosis because of background of CSOM in which it arises. 7 The patient presented with discharge and heaviness in left ear accompanied by discharge and swelling in postaural area. Initially, the diagnosis of CSOM atticoantral type with polyp, complicated by mastoid (zygomatic) abscess was made and incision and drainage was done.…”