Primary carcinoid tumor of the middle ear: a potentially metastasizing tumor

The concept of a carcinoid tumor in the gastrointestinal tract and lung is well established; less often, patients develop carcinoid tumors in the head and neck region. One particularly uncommon site of origin of carcinoid tumors in the head and neck area is the middle ear. Middle ear carcinoids have previously been approached as benign entities, lacking any capacity for metastasizing. A critical review of the literature, however, disclosed a small number of cases in which middle ear carcinoid tumors have given rise to regional (cervical node) metastases. This in turn suggests that, as is the case with pulmonary carcinoid tumors, middle ear carcinoids should be thought of as low-grade malignancies which, while relatively slow-growing, nevertheless possess a limited capacity for spreading to regional lymph nodes. To date, distant metastases have not been associated with middle ear carcinoid tumors.