Treatment of a local recurrence of a carcinoid tumor of the middle ear by extended subtotal petrosectomy

Knerer, Birgit; Matula, Ch.; Youssefzadeh, S.; Walter, Ulrich; Swoboda, Herwig

doi:10.1007/s004050050018

Cited by 22 publications

(24 citation statements)

References 10 publications

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“…Ramsey et al reported a case with facial paresis associated with invasion of the facial nerve and an intraneural spread [10]. Knerer et al reported another patient who required facial nerve sacrifice because of tumor involvement [11]. The carcinoid tumor belongs to the group of APUDomas (Amine Precursor Uptake and Decarboxylation) or endocrine cell tumors.…”

Section: Discussionmentioning

confidence: 99%

Middle ear glandular neoplasms: adenoma, carcinoma or adenoma with neuroendocrine differentiation: a case series

Saliba

Evrard

2009

Cases Journal

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IntroductionMiddle ear glandular neoplasms are infrequent causes of a middle ear mass. They can have exocrine and/or neuroendocrine differentiation. It is currently thought that these tumors are indistinguishable each from another. Herein, we present a new case of a middle ear glandular neoplasm. Our objective is to review all cases described in the literature in order to identify the clinical features, the gross pathology, the histopathology, the immunohistochemistry, to discuss the differential diagnosis, the treatment, the rate of recurrence, the follow-up, the incidence of metastasis, the prognosis and to present a new classification of middle ear glandular neoplasm.Case presentationMethodsWe performed a MEDLINE database search for MEA-related articles published between 1950 and March 2008. The information from the reports was analyzed.ResultsNinety-four patients with a middle ear adenoma are included in this report. We uncovered 75 patients with a carcinoid tumor and 19 patients with a middle ear adenoma diagnosis; the most common presenting symptom was a conductive hearing loss. Middle ear adenomas are lesions that are typically white, gray or reddish brown. They are grossly vascular and well circumscribed, but not encapsulated, and can entrap and destroy the ossicles. Histologically, the cuboidal to low columnar cells are arranged in a solid, trabecular or glandular architecture. The tumor's cells are immunohistochemically positive for a variety of keratin antibodies and most of them are also positive for neuroendocrine markers. Surgical excision is the treatment of choice. Local recurrence following complete excision is quite uncommon and metastases are rare.ConclusionsOur study and the review of the literature showed adenomas and carcinoid tumors of the middle ear to be essentially indistinguishable benign tumors with metastatic potential. Based on the presence or absence of immunohistochemical markers and metastasis, we have classified these lesions into three types. Complete surgical treatment is recommended with an indefinite follow-up for possible recurrence.

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Section: Discussionmentioning

confidence: 99%

Middle ear glandular neoplasms: adenoma, carcinoma or adenoma with neuroendocrine differentiation: a case series

Saliba

Evrard

2009

Cases Journal

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“…Local recurrence following attempts at curative excision is uncommon, but has been observed [13]. An unusual carcinoid tumor of the middle ear was described which occurred 1 year after the removal of a primary carcinoid of the ileum [14].…”

Section: Carcinoid Tumorsmentioning

confidence: 98%

Primary carcinoid tumor of the middle ear: A potentially metastasizing tumor

Ferlito

Devaney

Rinaldo

2006

Acta Oto-Laryngologica

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The concept of a carcinoid tumor in the gastrointestinal tract and lung is well established; less often, patients develop carcinoid tumors in the head and neck region. One particularly uncommon site of origin of carcinoid tumors in the head and neck area is the middle ear. Middle ear carcinoids have previously been approached as benign entities, lacking any capacity for metastasizing. A critical review of the literature, however, disclosed a small number of cases in which middle ear carcinoid tumors have given rise to regional (cervical node) metastases. This in turn suggests that, as is the case with pulmonary carcinoid tumors, middle ear carcinoids should be thought of as low-grade malignancies which, while relatively slow-growing, nevertheless possess a limited capacity for spreading to regional lymph nodes. To date, distant metastases have not been associated with middle ear carcinoid tumors.

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“…However, patients with extensive osteolytic spread of a middle-ear carcinoid as in the current subject have been reported [3, 4, 8, 9]. The MRI findings of the carcinoid tumors may not be useful for differentiation from other inflammatory diseases and other tumors; however, dynamic enhanced MRI in the present case showed carcinoid tumors to be enhanced earlier after the administration of Gd than granulation and other types of normal tissue.…”

Section: Discussionmentioning

confidence: 51%

“…One patient was initially treated with a petromastoidectomy for a tumor in the hypotympanicum extending into the external auditory canal without bone destruction [8], and another patient initially underwent a partial petrosectomy for the removal of middle-ear tumors extending into the hypotympanicum with partial erosion of the stapes superstructure [9]. Knerer et al described surgical treatment by extended subtotal petrosectomy for an extensive recurrent tumor with a close relationship to the tegmen tympani, facial nerve, and the ascending and horizontal portions of the carotid canal [3]. Menezes et al performed a craniotomy, petrosectomy, neck dissection, and parotidectomy for a recurrent carcinoid tumor, but the carcinoid tumor recurred within 3 months after the surgery [4].…”

Section: Discussionmentioning

confidence: 99%

“…A middle-ear carcinoid tumor is usually confined to the tympanum, and osteolytic extension of the tumor is rare [2]. Several patients show osteolytic invasion and cervical lymph node metastasis, suggesting that the middle-ear carcinoid should be classified as a low-grade malignancy [3–5]. The current report presents a patient with extensive osteolytic enlargement of a middle-ear carcinoid close to the jugular bulb and carotid artery canal, and also reviews the previous studies of carcinoid tumors of the middle ear.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment by Partial Petrosectomy for a Middle-Ear Carcinoid with Progressive Extension: A Case Report and Review of the Literature

Aoki

Mizuta

Ueda

et al. 2010

International Journal of Otolaryngology

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We herein report a 59-year-old male patient with a recurrent carcinoid tumor of the middle ear 7 years after a tympanomastoidectomy. The CT and dynamic MRI demonstrated an extensive tumor close to the carotid artery canal and the jugular bulb, and the tumor was removed by a partial petrosectomy with a transmastoid approach. The histopathological findings revealed a solid and trabecular tumor with cells positive for cytokeratin, chromogranin A, synaptophysin, and CD56. The MIB-1 antibody for the Ki-67 antigen was positive in 6.6% of the tumor cells. The relevant literature is reviewed in regard to the present case.

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Treatment of a local recurrence of a carcinoid tumor of the middle ear by extended subtotal petrosectomy

Cited by 22 publications

References 10 publications

Middle ear glandular neoplasms: adenoma, carcinoma or adenoma with neuroendocrine differentiation: a case series

Middle ear glandular neoplasms: adenoma, carcinoma or adenoma with neuroendocrine differentiation: a case series

Primary carcinoid tumor of the middle ear: A potentially metastasizing tumor

Surgical Treatment by Partial Petrosectomy for a Middle-Ear Carcinoid with Progressive Extension: A Case Report and Review of the Literature

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