Cholesteatoma triggering squamous cell carcinoma: case report and literature review of a rare tumor

Rothschild, Sacha; Ciernik, I. Frank; Hartmann, Matthias; Schuknecht, Bernhard; Lütolf, Urs M.; Huber, Alexander M.

doi:10.1016/j.amjoto.2008.06.011

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 4 , Pages 256-260, July 2009

Cholesteatoma triggering squamous cell carcinoma: case report and literature review of a rare tumor☆

Sacha Rothschild, MD
- Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
- Department of Medical Oncology, Bern University Hospital, Bern, Switzerland
- Corresponding author. Bern University Hospital, Department of Medical Oncology, 3010 Bern, Switzerland. Tel.: +41 31 632 4116; fax: +41 31 632 4116.
I. Frank Ciernik, MD
- Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Center for Clinical Research, Zurich University Hospital, University of Zurich, Zurich, Switzerland
Matthias Hartmann, PhD
- Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
Bernhard Schuknecht, MD
- Neuroradiology, MRI Institute Zurich, Zurich, Switzerland
Urs M. Lütolf, MD
- Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
Alexander M. Huber, MD
- Otorhinolaryngology, Zurich University Hospital, University of Zurich, Zurich, Switzerland

Received 5 February 2008 published online 09 February 2009.

Abstract

Background

The aim of this study was to report a case of squamous cell carcinoma of the petrous part of the temporal bone associated with a long history of secondary acquired cholesteatoma in a 71-year-old man.

Patients and methods

We present the case of a 71-year-old man \diagnosed with secondary acquired cholesteatoma in 1950. Treatments consisted of repetitive surgery owing to several relapses. In 2004, he presented with progressive fetid otorrhea. Clinical and computed tomography findings were indicative for relapsing cholesteatoma and a subtotal petrosectomy was performed.

Results

Histologic work-up demonstrated a moderately differentiated squamous cell carcinoma. The staging revealed stadium pT3 cN0 cM0. Postoperative treatment consisted of local radiation therapy with intensity-modulated beam geometry with a total of 64.2 Gy in 30 fractions using a simultaneous integrated boost.

Conclusion

Middle ear carcinoma can arise from acquired cholesteatoma. The pathogenesis of squamous cell carcinoma associated with cholesteatoma has not been elucidated satisfactorily. Due to the complex anatomic features, intensity-modulated radiation therapy is the technique of choice for postoperative radiotherapy.