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Temporal bone primary inverted papilloma - Case Report and review of the literature
Emilio Avallone1, Peter Raab2, Thomas Lenarz1
1Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Germany.
Abstract:
Inverted papilloma of middle ear is an extremely rare lesion of the respiratory epithelium that normally occurs in the nasal cavity and paranasal sinuses. So far less than 17 cases were described in literature. A 45-year-old patient was admitted in our Department with hearing loss, otorrhea and pulsing tinnitus on the right ear. The clinical examination showed a granulation tissue on the right eardrum. No tumor formation was seen in the nasal cavity. The MRI showed a tissue formation in the tympanic cavity with an extension in the middle cranial fossa. A mastoidectomy with antrotomy and duraplasty was performed. The histological diagnosis was inverted papilloma of the middle ear. In a second step occurred an eradication of the tumor with a subtotal petrosectomy. The etiology of the inverted papilloma of the middle ear is unknown. Our case is so far the 18nd case described.Our experience has shown that the eradication of the tumor with a subtotal petrosectomy resulted as reasonable procedure. A long-term follow-up is suggested in order to detect possible recurrence or malignant transformation.
Insights
Inverted papilloma of the middle ear, an extremely rare respiratory tumor, was diagnosed in an 18th case. Subtotal petrosectomy proved effective for tumor eradication, with long-term follow-up recommended.
Area of Science:
- Otolaryngology
- Pathology
Background:
- Inverted papilloma (IP) typically affects the sinonasal respiratory epithelium.
- Middle ear IP is exceptionally rare, with fewer than 17 prior cases documented.
Observation:
- A 45-year-old presented with right ear hearing loss, otorrhea, and tinnitus.
- Clinical exam revealed granulation tissue; MRI showed a tympanic cavity mass extending into the middle cranial fossa.
- Histopathology confirmed inverted papilloma of the middle ear.
Findings:
- This case represents the 18th documented instance of middle ear inverted papilloma.
- Surgical management involved mastoidectomy, antrotomy, duraplasty, followed by subtotal petrosectomy for tumor eradication.
Implications:
- Subtotal petrosectomy is a viable surgical approach for middle ear inverted papilloma.
- Long-term surveillance is crucial to monitor for recurrence or malignant transformation.
