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A Typical Bezold Abscess With an Atypical Aetiology
Maria Kiakou1, Anastasia Dimitriadi2, Aikaterini Tsagkovits3
1Ear, Nose, and Throat (ENT), St. George's Hospital, London, GBR.
Cureus
|January 10, 2025
Summary
A rare temporal bone paraganglioma presented unusually as a Bezold abscess, not typical hearing loss. Early diagnosis requires high suspicion and intraoperative biopsies for this jugulotympanic tumor.
Area of Science:
- Neuro-oncology
- Head and Neck Surgery
- Pathology
Background:
- Temporal bone paragangliomas (TBP) are rare neuroendocrine tumors.
- Typical presentations include hearing loss and pulsatile tinnitus.
- This case highlights an atypical clinical manifestation.
Observation:
- A 70-year-old female presented with cervical swelling and otorrhea.
- Imaging revealed a chronic middle ear process complicated by a Bezold abscess.
- Histopathology confirmed temporal bone paraganglioma.
Findings:
- The patient underwent surgery for the Bezold abscess.
- Histology showed a paraganglioma with Zellballen pattern and positive immunohistochemistry.
- This is the first reported case of jugulotympanic paraganglioma presenting as a Bezold abscess.
Implications:
- This case underscores the importance of considering rare pathologies in atypical presentations.
- Intraoperative biopsies are crucial for diagnosing such entities.
- A high index of suspicion is vital for timely and accurate diagnosis of temporal bone paragangliomas.
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