Middle Ear Carcinoid Tumour a Diagnostic Dilemma

Area of Science:

• Otolaryngology
• Neuroendocrine Tumors
• Oncology

Background:

• Carcinoid tumors, a type of neuroendocrine tumor, are typically found in the gastrointestinal tract and lungs.
• Middle ear carcinoid tumors are exceptionally rare, presenting diagnostic challenges due to nonspecific symptoms.

Purpose of the Study:

• To report a rare case of middle ear carcinoid tumor.
• To highlight the diagnostic and management approach for this unusual presentation.

Main Methods:

• A 29-year-old male presented with symptoms of ear blockage, hearing reduction, and tinnitus.
• Diagnostic workup included otoscopy, audiometry, CT scan, and histopathological examination with immunohistochemistry.
• Surgical excision of the mass was performed, followed by PET scanning to exclude metastasis.

Main Results:

• Otoscopy revealed tympanic membrane congestion and bulge; audiometry indicated conductive hearing loss.
• CT scan showed a mildly enhancing mass in the right middle ear.
• Histopathology and immunohistochemistry (Pan Cytokeratin, Synaptophysin, Chromogranin A positive, Ki-67 1%) confirmed a carcinoid tumor, likely an adenoma.
• Postoperative PET scan did not reveal any other primary tumor sites.

Conclusions:

• Middle ear carcinoid tumors, though rare, should be considered in the differential diagnosis of middle ear masses presenting with hearing loss.
• Complete surgical excision is the primary treatment modality.
• Multidisciplinary evaluation including imaging and immunohistochemistry is crucial for accurate diagnosis and staging.