Primary adenocarcinoma of the temporal bone with posterior fossa extension: case report

Primary adenomatous tumors of the middle ear and mastoid are rare. We recently cared for a man with a far-advanced primary adenocarcinoma of the middle ear and mastoid. Complete tumor removal was accomplished by a modified infratemporal fossa approach and was supplemented with postoperative radiation therapy. The postoperative complications of aspiration pneumonia and cerebrospinal fluid (CSF) leakage through the wound stimulated subsequent incorporation of temporary gastrostomy and CSF shunting into our surgical procedure. Now, 23 months after surgery, the patient is without evidence of recurrent disease. His case illustrates our approach to the management of such extensive temporal bone lesions as well as some of the potential problems which may be encountered.