PMC3420775_01
Right inner ear and temporal bone computed tomography scan on first admission (a) and on readmission (b) showing opacification of the right external auditory canal, right tympanic, and epitympanic spaces, as well as the right mastoid antrum. There is also bony destruction of the anterior wall of the right external auditory canal, scutum and wall of the right carotid canal, foramen lacerum, and semicircular canals. The arrows show the extent of tumor spread into the middle ear.
CRIM.OTOLARYNGOLOGY2011-615210.001.jpg
PMC3420775_01_CRIM.OTOLARYNGOLOGY2011-615210.001.jpg
fig1
The CT also showed destructive changes of the anterior wall of the right external auditory canal, scutum wall of the right carotid canal and foramen lacerum, and wall of the right semicircular canal (Figure 1).
Neck soft tissue Magnetic resonance imaging showing heterogeneous signal abnormality and enhancement centered about the right external auditory canal and middle ear region. The arrow depicts spread of the tumor into the middle ear.
CRIM.OTOLARYNGOLOGY2011-615210.002.jpg
PMC3420775_01_CRIM.OTOLARYNGOLOGY2011-615210.002.jpg
fig2
A magnetic resonance imaging scan of the neck revealed extensive heterogeneous signal abnormality and enhancement centered about the right external auditory canal and middle ear region (Figure 2). T4NO disease based on radiological CT imaging of the right ear which showed that the tumor has penetrated through the right external auditory canal into the scutum and walls of the right carotid and foramen lacerum. There was also evidence on the CT and MRI showing local invasion of the facial nerve in the middle ear (Figure 2); this was thought to be the cause of her facial paralysis.
Showing well-differentiated squamous cell carcinoma, characterized by sheets of cells with large cells with pleomorphic, hyperchromatic nuclei and individual cell keratinization, and keratin pearl formation.
CRIM.OTOLARYNGOLOGY2011-615210.003.jpg
PMC3420775_01_CRIM.OTOLARYNGOLOGY2011-615210.003.jpg
fig3
The pathology report showed a well-differentiated squamous cell carcinoma (Figure 3).