鼓室形成術11年後に発症した聴器癌例

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  • A Case of Temporal Bone Carcinoma That Developed 11 Years After Tympanoplasty
  • コシツケイセイジュツ 11ネンゴ ニ ハッショウ シタ チョウキガンレイ

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<p>It has been reported patients with temporal bone carcinoma often have a past history of chronic ear disease. We report a case of temporal bone carcinoma that developed 11 years after tympanoplasty. A 45-year-old male patient with a history of having undergone his first tympanoplasty in childhood was referred to our hospital with recurrent left otorrhea. Examination revealed perforation of the tympanic membrane and granulation in the middle ear on the left side. We performed a second tympanoplasty, and the otorrhea remained under control for 10 years. In the 11th year, however, the left otorrhea recurred, with otalgia. The findings of otorrhea and redness of the left tympanic membrane and mastoid cavity led to the suspicion of ear infection. However, treatment with antibiotic eardrops proved ineffective. The finding of bone erosion on CT and enhancement of the dura mater and bone marrow of the temporal bone on MRI were suggestive not only of ear infection, but also of skull base osteomyelitis. Intravenous antibiotic treatment proved ineffective. Finally, 6 months after the reappearance of otorrhea, the patient was diagnosed as having squamous cell carcinoma of the temporal bone based on the histopathological findings of a second biopsy. Temporal bone CT two months after the completion of chemoradiotherapy revealed residual carcinoma. We recommended the next course of treatment to the patients, but he refused any additional treatment and died within 6 months. This patient developed temporal bone carcinoma even in the absence of otorrhea for a long period. Repeated biopsies may be needed to diagnose carcinoma, in patients with a past history of chronic ear disease presenting with refractory otorrhea.</p>

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