Unusual Presentation of a Metastatic Tumor to the Temporal Bone: Severe Otalgia and Facial Paralysis

Abstract

Metastatic temporal bone tumors are rare diseases and they are usually clinically asymptomatic, so it is difficult to diagnose them. Breasts are the most common sites of temporal bone metastasis. Tumors of lung, kidney, gastrointestinal tract, prostate gland, larynx and thyroid gland are the other sites. The pathogenesis of the temporal bone is most commonly related to the hematogenous route. We present the case of a 78-year-old man with facial paralysis combined with severe otalgia. This patient was initially diagnosed with Bell's palsy. However, based on the radiologic findings, the patient was diagnosed with lung cancer with temporal bone metastasis.

Metastatic Prostate Cancer to the Left Temporal Bone: A Case Report and Review of the Literature

“…Metastatic cancer involving the temporal bone is often asymptomatic and may be underreported; however, the incidence appears to be rising due to an aging population and better diagnostic modalities that spur improved recognition [ 13 , 19 , 21 , 22 ]. Approximately 21 cases of prostate cancer metastases to the temporal bone have been reported in the literature; however, our report is only the 3rd case of metastasis >10 years from the diagnosis and treatment of a primary tumor.…”

“…The nonspecific features of temporal bone malignancy can make diagnosis difficult; therefore, considering a broad differential diagnosis is important. Possible causes of symptoms that may mimic malignancy are multiple myeloma, chondrosarcoma, chordoma, invasive meningiomas, schwannomas, and petrous apicitis ( Table 2 ) [ 17 , 19 , 25 ]. Making the diagnosis requires imaging and eventual biopsy.…”

“…Treatment with surgery, radiation, and chemotherapy is aimed at palliation [ 19 ]. Surgery is usually required for tissue diagnosis and may be used for debulking and symptomatic patients.…”

“…Patients with metastatic cancer of the temporal bone may be asymptomatic [ 14 – 16 ]. However, hearing loss, facial palsy, and/or signs similar to mastoiditis (e.g., otalgia, ear drainage, and vertigo) can be seen [ 17 – 19 ]. Due to the low incidence of cases of metastatic prostate cancer, the infrequent involvement in the skull, and the nonspecific symptoms patients present with, metastatic prostate cancer of the temporal bone may be difficult to diagnose.…”

Hearing loss due to metastasis of gastric cancer to temporal bone: A case report

“…5 and 6 , respectively). Previous patients who were clinically diagnosed with metastasis to the temporal bone received radiotherapy with a total dose of 60 Gy for the treatment of the tumor mass ( 6 ). Therefore, this treatment was also applied to the patient of the present case report, who is currently under treatment and has been under observation for one year.…”