PMC3420551_01
Otoscopy of the left ear. The subcutaneous, bulging tumor was seen from the flaccid part to the umbo of the left tympanic membrane.
CRIM.OTOLARYNGOLOGY2012-690148.001.jpg
PMC3420551_01_CRIM.OTOLARYNGOLOGY2012-690148.001.jpg
fig1
Examination of the ear revealed a bulging, subcutaneous bulging tumor from the flaccid part to the umbo of the left tympanic membrane (Figure 1).
Temporal bone computed tomographic scan shows soft tissue shadow from the bone destruction with massive extension to the epitympanum and ossicular chain (a). In the coronal section, the tumor invades the skull base, and the outline of the tumor shows osteosclerosis with decalcification (b). Magnetic resonance imaging of the head revealed a mass 3 cm in diameter at the left temporal bone that was unequally enhanced after intravenous gadolinium (c). At the coronal section, the border with the tumor and the left mandible head was indistinct. In addition, the dura mater of the middle cranial fossa showed enhancement (d).
CRIM.OTOLARYNGOLOGY2012-690148.002.jpg
PMC3420551_01_CRIM.OTOLARYNGOLOGY2012-690148.002.jpg
fig2
CT of the temporal bone showed a soft-tissue-density specification indicating bone destruction, 3 cm in size, at the left temporal bone with massive extension to the mastoid antrum and the temporomandibular joint (Figure 2(a)). In the coronal section, the tumor invaded the skull base, and the outline of the tumor showed osteosclerosis with decalcification (Figure 2(b)). After intravenous gadolinium, the mass showed unequal enhancement (Figure 2(c)). In addition, the dura mater of the middle cranial fossa appeared to be involved by the tumor based on the dural enhancement (Figure 2(d)).
Intraoperative photographs. Transmastoid and middle fossa approach. The tumor was peeled from the middle fossa dura. Arrowhead: giant cell tumor, arrow: dura of the middle cranial fossa.
CRIM.OTOLARYNGOLOGY2012-690148.003.jpg
PMC3420551_01_CRIM.OTOLARYNGOLOGY2012-690148.003.jpg
fig3
We removed the tumor using transmastoid and middle fossa approach (Figure 3).
HE staining from the specimens of the tumor. Round and spindle-shaped mononuclear cells and numerous multinucleated giant cells. Arrow: giant cell.
CRIM.OTOLARYNGOLOGY2012-690148.004.jpg
PMC3420551_01_CRIM.OTOLARYNGOLOGY2012-690148.004.jpg
fig4