Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 5, pp 1607–1613 | Cite as

The misdiagnosis of external auditory canal carcinoma

  • Ting Zhang
  • ChunFu Dai
  • ZhengMin Wang
Otology

Abstract

External auditory canal (EAC) carcinomas are frequently misdiagnosed. The aim of this study was to conduct a review of misdiagnosed cases and analyze the factors involved. This study was a retrospective assessment. Eighteen of 44 EAC carcinoma cases seen at the Eye and ENT Hospital were misdiagnosed. All medical records were retrospectively analyzed for the age, sex, presenting symptoms, type of misdiagnosis, computed tomographic (CT) or magnetic resonance imaging (MRI) findings, stage of the cancer, surgical approach, histopathological examination, adjunctive therapy (postoperative radiotherapy) and outcomes of treatment. Six cases were misdiagnosed as otitis media, five cases were misdiagnosed as otitis externa, and two cases were misdiagnosed as external auditory canal cholesteatomas. Other misdiagnoses were stenosis of the EAC, ear neuralgia, furuncle of the EAC, benign neoplasm of the EAC and pre-auricular fistula. Our analyses suggest that a biopsy should be conducted to obtain a histopathological diagnosis if an EAC carcinoma is suspected, in case otitis media or otitis externa does not respond to routine anti-bacterials. Head and neck MRI should be used to explore the involvement of soft tissues. Patients with bloody ear discharge and otalgia, particularly with temporal bone erosion seen in a CT scan, are highly likely to have a malignant carcinoma of the temporal bone.

Keywords

External auditory canal carcinoma Misdiagnosis Surgery Temporal bone 

Notes

Acknowledgments

This work was supported by a project on Advanced and Frontier Techniques for Shanghai Municipal Hospital (SHDC12010119), and Shanghai Talent Program-08-039.

References

  1. 1.
    Kuhel WI, Hume CR, Selesnick SH (1996) Cancer of the external auditory canal and temporal bone. Otolaryngol Clin North Am 29:827–852PubMedGoogle Scholar
  2. 2.
    Nakagawa T, Kumamoto Y, Natori Y et al (2006) Squamous cell carcinoma of the external auditory canal and middle ear: an operation combined with preoperative chemoradiotherapy and a free surgical margin. Otol Neurotol 27:242–248 (Discussion 249)PubMedCrossRefGoogle Scholar
  3. 3.
    Gidley PW (2009) Managing malignances of external auditory canal. Expert Rev Anticancer Ther 9:1277–1282PubMedCrossRefGoogle Scholar
  4. 4.
    Moddy SA, Hirsch BE, Myers EN (2000) Squamous cell carcinoma of the external auditory canal: an evaluation of a staging system. Am J Otol 21:582–588Google Scholar
  5. 5.
    Crabtree JA, Britton BH, Pierce MK (1976) Carcinoma of the external auditory canal. Laryngoscope 86:405–415PubMedCrossRefGoogle Scholar
  6. 6.
    Leonetti JP, Smith PG, Kletzker GR et al (1996) Invasion patterns of advanced temporal bone maligancies. Am J Otol 17:438–442PubMedGoogle Scholar
  7. 7.
    Moffat DA, Wagstaff SA (2003) Squamous cell carcinoma of the temporal bone. Curr Opin Otolaryngol Head Neck Surg 11:107–111PubMedCrossRefGoogle Scholar
  8. 8.
    Rothschild S, Ciernik IF, Hartmann M et al (2009) Cholesteatoma triggering squamous cell carcinoma: case report and literature review of a rare tumor. Am J Otolaryngol 30:256–260PubMedCrossRefGoogle Scholar
  9. 9.
    Rosenfeld RM, Brown L, Cannon CR et al (2006) Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg 134:S4–S23PubMedCrossRefGoogle Scholar
  10. 10.
    Pensak ML, Gleich LL, Gluckman JL et al (1996) Temporal bone carcinoma: contemporary perspectives in the skull base surgical era. Laryngoscope 106:1234–1237PubMedCrossRefGoogle Scholar
  11. 11.
    Arriaga M, Curtin HD, Takahashi H et al (1991) The role of preoperative CT scans in staging external auditory meatus carcinoma: radiologic-pathologic correlation study. Otolaryngol Head Neck Surg 105:6–11PubMedGoogle Scholar
  12. 12.
    Yu Y, Zhang R, Dai C (2009) The study on the en bloc resection of the external auditory canal to treat external auditory canal carcinoma in the early stage. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 23:313–315PubMedGoogle Scholar
  13. 13.
    Kunst H, Lavieille JP, Marres H (2008) Squamous cell carcinoma of the temporal bone: results and management. Otol Neurotol 29:549–552PubMedCrossRefGoogle Scholar
  14. 14.
    Chi FL, Gu FM, Dai CF et al (2011) Survival Outcomes in Surgical Treatment of 72 Cases of Squamous Cell Carcinoma of the Temporal Bone. Otol Neurotol 32:665–669PubMedCrossRefGoogle Scholar
  15. 15.
    Ito M, Hatano M, Yoshizaki T (2009) Prognostic factors for squamous cell carcinoma of the temporal bone: extensive bone involvement or extensive soft tissue involvement. Acta Otolaryngol 129:1313–1319PubMedCrossRefGoogle Scholar
  16. 16.
    Madsen AR, Gundgaad MG, Hoff CM et al (2008) Cancer of the external auditory canal and middle ear in Denmark from 1992 to 2001. Head Neck 30:1332–1338PubMedCrossRefGoogle Scholar
  17. 17.
    Cristalli G, Manciocco V, Pichi B et al (2009) Treatment and outcome of advanced external auditory canal and middle ear squamous cell carcinoma. J Craniofac Surg 20:816–821PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat HospitalFudan UniversityShanghaiChina

Personalised recommendations