Cases reported "Ear Neoplasms"

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1/82. Primary pleomorphic adenoma of the external auditory canal diagnosed by fine needle aspiration cytology. A case report.

    BACKGROUND: Pleomorphic adenoma (PA) arising in the external auditory canal (EAC) is a very rare neoplasm, thought to be derived from ceruminous glands. CASE: A 43-year-old male presented with a slowly growing mass in the right EAC. Clinical and radiologic examinations showed a well-circumscribed tumor limited to the EAC, without a connection to the parotid gland. Fine needle aspiration cytology (FNAC) revealed the typical cytologic findings of PA. The diagnosis was confirmed by histologic examination. CONCLUSION: This case illustrates that together with clinical and radiologic findings, primary PA of the EAC can confidently be diagnosed by FNAC.
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2/82. Malignant eccrine poroma in an elderly African-American woman.

    BACKGROUND: eccrine porocarcinoma is a rare, slow-growing malignant tumor arising from the eccrine sweat gland. OBJECTIVE: We present a case of eccrine porocarcinoma of the ear in an elderly African-American woman. Cases of eccrine porocarcinoma have been reported in the literature occurring in facial, extremity, scalp, and genital sites and primarily in Caucasian patients. Rarely are cases described in African-American patients or on the ear. methods: We describe the history of the lesion, discuss the current cancer statistics for skin cancer in african americans, and histology and treatment choices are compared with previously reported cases. RESULTS: We present a case of malignant eccrine poroma of the ear in a 71 year old African-American woman. The tumor was completely excised by mohs surgery. Transposition flap repair of the Mohs surgical defect was performed. CONCLUSIONS: While african americans are at low risk of developing skin cancers, it is important to remember that skin cancers can affect patients of any ethnicity and skin tone. Treatment regimens for skin cancers in African-American patients must be chosen appropriately by site of tumor, size of tumor and extent of disease as would be expected for any skin cancer.
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3/82. Middle ear adenoma with neuroendocrine differentiation.

    The lining of the middle ear cleft is normally a thin modified respiratory type mucosa. Normal mucosa of the middle ear is devoid of salivary type seromucous glands. Middle ear adenoma is a rare tumor that seems to be derived from the middle ear mucosa. This tumor has been previously described under a variety of names because of its different nature and biological behavior. We herein report a case of middle ear tumor that shows adenomatous and neuroendocrine features. A 64-year-old woman presented with a history of hearing loss, tinnitus and stuffy feeling of the right ear. The patient was treated two times for ear polyp. She finally underwent a tympanomastoidectomy and there was no evidence of recurrence 18 months after the procedure. Histopathological examination displayed cuboidal and columnar cells, arranged as glands, trabeculae and solid sheets. Neuroendocrine differentiation was revealed by immunohistochemical staining with polyclonal antibodies against neuron specific enolase and chromogranin antigens.
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4/82. Middle ear adenoma is an amphicrine tumor: why call it adenoma?

    Middle ear adenoma (MEA) is a rare tumor postulated to take origin from the lining epithelium of the middle ear cavity. The authors report on a case of MEA arising in a 53-year old woman suffering from a sensation of fullness in her left ear, otalgia, and light left-sided hearing loss. Histopathologically, the lesion was composed of cuboidal and polygonal cells displaying a trabecular, tubulo-glandular, and solid pattern of growth. Immunohistochemically, neoplastic cells diffusely stained with anti-vimentin antibodies and were focally positive for chromogranin a, neuron-specific enolase, lysozyme, and cytokeratins AE1/AE3. The majority of tumor cells showed weak and diffuse staining with both anti-PP and anti-ACTH antibodies and intense positivity with anti-glucagon and anti Leu-7 antibodies. Ultrastructural investigation revealed both mucinous-glandular and neuroendocrine differentiation. The authors suggest that the appropriate terminology would be adeno-carcinoid or amphicrine tumor of the middle ear rather than "adenoma," a term that does not reflect its dual nature.
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5/82. Mature teratoma of the middle ear.

    OBJECTIVE: The authors report a case of mature teratoma of the middle ear in a 3-year-old girl with a 1-year history of otitis media. methods AND RESULTS: Radiologic investigation revealed a partially cystic lesion of the petrous portion of the right temporal bone. It produced opacification of the middle ear as well as destruction of septal air cells. The patient underwent a subtotal petrosectomy. Histologically, the tumor was composed of an intimate admixture of mature tissues representing all three germ layers, including brain, myelinated nerve trunks, skeletal muscle, bone, immature cartilage, seromucinous glands, and respiratory epithelium. Of note within the brain tissue was choroid plexus within an ependyma-lined rudimentary ventricle. Immunohistochemical studies were also performed. Twenty months after surgery, the patient was well, with complete recovery from symptoms. CONCLUSION: Teratomas of the middle ear are rare neoplasms. Only a few examples have been reported. As a rule, they are cured by resection and do not require adjuvant therapy.
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6/82. Aspiration cytopathology of middle-ear neuroendocrine carcinoma.

    Primary neuroendocrine carcinoma (carcinoid tumor) is among the rarest of middle-ear (ME) neoplasms, with only a rare case of metastatic disease having been reported. Fine-needle aspiration biopsy (FNAB) was performed in a 51-yr-old male with a two-decade history of multiple local recurrences from a right middle-ear neoplasm, with the most recent surgical excision 2 yr ago. He currently presented with an enlarged right parotid gland, and a right infratemporal mass. Aspirate smears showed a monotonous population of cytologically bland cells with a small to moderate amount of pale granular cytoplasm, round to oval nuclei, inconspicuous nucleoli, and finely granular chromatin. Rare, isolated large cells were occasionally seen. Immunohistochemical staining of the cell block made from the aspirated material showed strong cytoplasmic positivity for chromogranin, synaptophysin, neuron-specific enolase (NSE), serotonin, and cytokeratin cocktail, and negative staining for S100 protein. review of tissue slides from the patient's prior middle-ear tumor showed an identical immunoprofile and morphology, and led to a revision of the original diagnosis of paraganglioma. Middle-ear neuroendocrine carcinoma has a low but definite metastatic potential, which can be diagnosed using FNAB if ancillary immunohistochemical studies are available.
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7/82. magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo.

    OBJECTIVE: The etiopathogenesis in audiovestibular symptoms can be elusive, despite extensive differential diagnosis. This article addresses the value of magnetic resonance imaging (MRI) in analysis of the complete audiovestibular pathway. STUDY DESIGN: Retrospective evaluation. SETTING: Tertiary referral center. patients: Consecutive sample of 354 patients (mean age 49 years, range 8 to 86 years) with audiovestibular disorders. INTERVENTION: Contrast-enhanced MRI of the head with thin-slice investigation of the inner ear, internal auditory meatus, and cerebellopontine angle. MAIN OUTCOME MEASURE: All MRIs were evaluated by experienced independent investigators. Statistical analysis was performed using the Statistical Package of social sciences data analysis 9.0. RESULTS: MRI abnormalities were seen in 122 of 354 patients (34.5%). The MRIs revealed the following: 4 pathologic conditions (1.1%) of the cochlea/labyrinth, 23 abnormalities (6.5%) at the internal auditory meatus/cerebellopontine angle, 12 pathologic lesions (3.4%) that involved the central audiovestibular tract at the brainstem, 78 microangiopathic changes of the brain (22%), 3 focal hyperintensities of the brain that turned out to be the first evidence of multiple sclerosis in 2 patients and sarcoidosis in 1 patient, and 1 temporal metastasis. Other pathologic conditions, such as parotid gland or petrous bone apex tumors, were unrelated to the audiovestibular symptoms. CONCLUSIONS: This study indicates that contrast-enhanced MRI can be used to assess a significant number of different pathologic conditions in patients with audiovestibular disorders.
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8/82. Ceruminous gland adenoid cystic carcinoma with contralateral metastasis to the brain.

    We present the case of a 38-year-old man with an adenoid cystic carcinoma originating from the ceruminous glands of the external ear canal. The patient subsequently presented with a contralateral brain mass that was also diagnosed as adenoid cystic carcinoma. To our knowledge, contralateral metastasis to the brain of a patient with an adenoid cystic carcinoma of the ceruminous glands has not been reported previously. This rare neoplasm should be considered in the differential diagnosis of poorly differentiated carcinomas metastatic to the central nervous system in patients with occult malignant neoplasms.
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9/82. Postauricular sebaceous carcinoma arising in association with nevus sebaceus.

    BACKGROUND: Sebaceous carcinoma is an uncommon malignant neoplasm usually associated with the ocular adnexa. Despite the widespread anatomic distribution of sebaceous glands, extraocular sebaceous carcinoma occurs with far less frequency. methods: A 27-year-old man was examined with the presenting complaint of a slowly enlarging subcutaneous mass. It was associated with an overlying, irregular, verrucoid epidermal plaque. RESULTS: Histologic and electron microscopic examination of the mass revealed a malignant sebaceous neoplasm occurring in conjunction with an overlying nevus sebaceus. The dermal neoplasm contained numerous cytoplasmic and stromal hyaline globules. CONCLUSIONS: We report a case of extraocular sebaceous carcinoma arising in the postauricular region in association with a nevus sebaceus and exhibiting the unusual histologic feature of hyaline globules.
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10/82. Primary adenocarcinoma of the middle ear.

    Primary adenocarcinoma of the middle ear is rare. It may or may not be associated with chronic suppurative otitis media. After the exclusion of a primary site elsewhere, the tumor should be managed by surgery and postoperative radiotherapy, especially if tumor excision is incomplete. We report a case in which primary papillary adenocarcinoma developed in the middle ear, possibly due to aberrant ceruminous gland elements. The findings prior to histologic examination were unusual in that they were consistent with a tumor of the glomus tympanicum or glomus jugulare.
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