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    Ear Carcinoma

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    boy jendri hulu
    Tumor of the ear, especially squamous cell carcinoma, is rare but can occur in the external ear canal, middle ear, or mastoid. Common symptoms include ear discharge, bleeding, pain, and facial nerve paralysis. Diagnosis involves CT, MRI, and chest imaging to determine extent of disease. Treatment involves wide surgical excision, sometimes with temporal bone resection or neck dissection, along with radiation and chemotherapy. Prognosis depends on stage, with 5-year survival rates of 100% for early stage disease but only 19.6% for late stage or metastatic disease.

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    Ear Carcinoma

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    boy jendri hulu
    88 views23 pages
    Tumor of the ear, especially squamous cell carcinoma, is rare but can occur in the external ear canal, middle ear, or mastoid. Common symptoms include ear discharge, bleeding, pain, and facial nerve paralysis. Diagnosis involves CT, MRI, and chest imaging to determine extent of disease. Treatment involves wide surgical excision, sometimes with temporal bone resection or neck dissection, along with radiation and chemotherapy. Prognosis depends on stage, with 5-year survival rates of 100% for early stage disease but only 19.6% for late stage or metastatic disease.

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    Tumor of the ear, especially squamous cell carcinoma, is rare but can occur in the external ear canal, middle ear, or mastoid. Common symptoms include ear discharge, bleeding, pain, and facial nerve paralysis. Diagnosis involves CT, MRI, and chest imaging to determine extent of disease. Treatment involves wide surgical excision, sometimes with temporal bone resection or neck dissection, along with radiation and chemotherapy. Prognosis depends on stage, with 5-year survival rates of 100% for early stage disease but only 19.6% for late stage or metastatic disease.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    88 views23 pages

    Ear Carcinoma

    Uploaded by

    boy jendri hulu
    Tumor of the ear, especially squamous cell carcinoma, is rare but can occur in the external ear canal, middle ear, or mastoid. Common symptoms include ear discharge, bleeding, pain, and facial nerve paralysis. Diagnosis involves CT, MRI, and chest imaging to determine extent of disease. Treatment involves wide surgical excision, sometimes with temporal bone resection or neck dissection, along with radiation and chemotherapy. Prognosis depends on stage, with 5-year survival rates of 100% for early stage disease but only 19.6% for late stage or metastatic disease.

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    © All Rights Reserved
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    of 23

    TUMOR OF THE EAR

    dr. Yuliani M Lubis, SpTHT-KL


    INTRODUCTION

    • Carcinoma of the external auditory canal (EAC) is rare.


    • The outcome of this disease is related to the stage of the
    lesion
    • Among EAC carcinomas, squamous cell carcinoma
    (SCC) is the most common malignant tumour at
    this site.
    • Early presentation of symptoms and signs makes early
    diagnosis and intervention possible.

    The Journal of Laryngology & Otology (2006), 120, 684–686.


    INCIDENCE
    • Estimates of incidence are in the range
    of 6 cases per million, with a median age of
    occurrence at 55 years.
    • 60% of malignancies affect the auricle
    • 28% in the external auditory canal
    • 12% in the midlle ear and mastoid

    ORL: Journal for Oto-Rhino-Laryngology and Its Related Specialties Jul/Aug 2001:63;4
    ETIOLOGY

    • Chronic ear discharge and infection with aspergillus


    and pseudomonas and radiation may be regarded as
    risk factors of inducing SCC at this site.
    • In the middle ear SCC, two factor associated are:
    Chronic Otitis Media and irradiation
    • High prevalence of human papillomavirus types 16 and
    18 in COM → Patogenesis chronic inflamation related
    human malignancies.
    The Journal of Laryngology and Otology; Oct 2001; 115, 10; ProQuest Medical Library
    HISTOPATOLOGY
    • Most tumours of the auricle are basal cell
    carcinoma (BCC) in contrast to squamous cell
    carcinoma (SCC) that affect the external
    auditory canal and middle ear.
    • Other cancers of the temporal bone include
    adenocarcinoma, melanoma and sarcoma.
    HISTOPATOLOGY
    • Carcinomas of the external auditory canal
    include: SCC, basal cell-, adenoid cystic-,
    ceruminous-, microcystic, adnexal carcinoma,
    and adenocarcinoma.
    • Among them the SCC represents the most
    common form of EAC
    CLINICAL FINDING
    TUMOURS IN EXTERNAL EAR
    • Long standing ear discharge
    • Blood staining of mucopurulent or purulent
    discharge and severe earache.
    • Examination : ulcerated area in the meatus or
    a bleeding polypoid mass or granulations.
    • Facial nerve paralysis
    • Regional lymph node may be involved
    CLINICAL FINDING
    • TUMOURS IN THE MIDDLE EAR AND
    MASTOID
    Deafness and tinnitus
    Profuse bleeding from the ear
    Dizziness or vertigo
    Facial paralysis
    Cranial nerve palsies : n. IX – XII
    • Symptoms of Ca of the Auditory organs:
    • Otorrhea
    • Otalgia
    • Ear bleeding
    • Facial nerve paralysis

    The Journal of Laryngology and Otology: Oct 2001,115


    TUMOURS EXTENSION

    • Lession affecting the EAC rarely metastasize


    • Extension anteriorly and inferiorly → fissure
    Santorini/foramen of Huschke →
    temporomandibular joint.
    • Superior extension through he tegmen of the
    mastoid or middle ear places disease in direct
    proximity to temporal lobe of the brain in the
    middle cranial fossa
    ORL : Journal for Oto - Rhino - Laryngology and Its Related Specialties; Jul/Aug 2001; 63, 4;
    TUMOURS EXTENSION
    • Posterior extension places the facial nerves at risk
    as tumor extend s into the mastoid process
    • Medial extension of tumor within the middle ear
    may cause involvement of the jugular bulb and
    carotid artery
    • Distant metastasis is usually an extremely rare
    event.

    ORL :Journal for Oto - Rhino - Laryngology and Its Related Specialties; Jul/Aug 2001; 63, 4;
    Squamous cell carcinoma in the midlle ear mastoid
    TUMOURS OF EXTERNAL
    EAR PINNA
    External ear canal
     BENIGN  BENIGN
    • Preauricular cyst or sinus • Osteoma
    • Sebaceous cyst • Exostosis
    • Dermoid cyst • Ceruminoma
    • Keloid
    • Haemangioma
    • Sebaceous adenoma
    • Papilloma • Papilloma
    • Cutaneous horn
    • Keratoachantoma  MALIGNANT
    • Neurofibroma • Squamous Cell Carcinoma
    • Basal Cell Carcinoma
     MALIGNANT • Adenocarcinoma
    • Squamous Cell Carcinoma • Malignant ceruminoma
    • Basal Cell Carcinoma
    • Melanoma
    • Melanoma
    DIAGNOSE

     CT Scan head
     MRI → soft tissue extent of tumour
     Chest CT scan → most sensitive in
    identifying and localizing pulmonary metastasis
     Plain chest x-rays are much more easily available
    and serves as a useful screening tool.
    ORL : Journal for Oto - Rhino - Laryngology and Its Related Specialties; Jul/Aug 2001; 63, 4;
    STAGING

    • Carcinomas of the EAC can be staged using the


    American Joint Committee on Cancer (AJCC)
    general staging system for non melanoma
    cancer of the skin, which is a TNM (tumor,
    node, metastases) staging system.
    TREATMENT
    • Wide surgical excision of EAC, tympanic
    membrane,
    • Temporal bone resection
    • Radical neck dissection
    • Radiation
    • Chemotherapy
    PROGNOSE
    • 5 years survival rates in cases of stage I+II
    (tumour confined to auditory canal) were
    100%
    • Stage II (tumour involving the middle ear or
    mastoid) 68,6%
    • Stage IV 19,6%
    • Atsushi Takano
    • The Journal of Laryngology and Otology; Oct 2001; 115, 10;
    THANK YOU

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