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Primary lymphoma of the temporal bone
D L Tucci1, P R Lambert, D J Innes
1Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Abstract:
Involvement of the temporal bone by lymphoreticular neoplasm is rare; all reported cases have been of secondary involvement. This article presents what we believe to be the first two reported cases of primary temporal bone lymphoma. The patients, an elderly man and a boy, both presented with infection of the ear, hearing loss, and facial nerve paresis. In both cases, facial paresis resolved after appropriate chemotherapeutic treatment. Patient presentation and clinical course are discussed in light of published work on temporal bone malignancy. Further investigation, including computed tomography and biopsy, should be considered for patients who present with an apparent middle ear infection unresponsive to medical therapy. The development of facial paralysis in such a patient warrants heightened suspicion of malignancy.
Insights
Primary temporal bone lymphoma is rare, with only two cases reported. Patients presented with ear infection, hearing loss, and facial nerve issues, which resolved with chemotherapy.
Area of Science:
- Oncology
- Otolaryngology
- Neurology
Background:
- Lymphoreticular neoplasms rarely involve the temporal bone, typically as secondary sites.
- Primary temporal bone lymphoma is exceptionally uncommon in medical literature.
Observation:
- Two cases of primary temporal bone lymphoma are presented: an elderly man and a boy.
- Both patients exhibited symptoms of ear infection, hearing loss, and facial nerve paresis.
Findings:
- Facial nerve paresis in both patients resolved following chemotherapeutic intervention.
- The study highlights the importance of considering malignancy in persistent middle ear infections with facial paralysis.
Implications:
- Computed tomography and biopsy are recommended for unresponsive middle ear infections.
- Facial paralysis in this context should raise suspicion for underlying malignancy, necessitating further investigation.