Middle Ear Carcinoid Tumour a Diagnostic Dilemma

Carcinoid tumours are neuroendocrine tumours associated with gastrointestinal tract, lungs and rarely seen in middle ear. A 29 year old male presented with nonspecific symptoms of blocking sensation, reduced hearing and tinnitus in the right ear. Otoscopy showed congestion of right tympanic membrane with bulge in anterior quadrant with no blanching on siegalization. Audiometry showing conductive hearing loss. CT scan showing mildly enhancing mass in the right middle ear cavity. Complete excision was done and Histopathological studied showed features favouring adenoma and immunohistochemistry showed positive staining of Pan Cytokeratin, Synaptophysis and Chromogranin A, with Ki-67 01% suggestive of carcinoid tumour. Patient underwent PET Scaning post operatively to rule out carcinoid tumour elsewhere in the body. Patient is on follow-up every month to look for any recurrence.