Zeise K, Kaschke O, Jautzke G
HNO-Abteilung, St. Gertrauden-Krankenhaus, Paretzer Strasse 12, 10713 Berlin.
HNO. 2001 Feb;49(2):130-3. doi: 10.1007/s001060050722.
Adenomas of the middle ear are rare benign glandular neoplasms arising from the middle ear mucosa. After previous operations 25 and 15 years before, a 67-year-old female complained about dizziness, tinnitus, and unilateral hearing loss on the left side. A tumor in the tympanum that was revealed by otoscopy could be removed completely. Histological examinations showed an adenoma of the middle ear with cholesteatoma. This was inconsistent with the histological result of the operation in 1983, which had described a hidradenoma. An exact analysis of the preparations confirmed that a middle ear adenoma had already been present in 1983. Hidradenoma is one of the most important differential diagnoses. The characteristic histological sign of middle ear adenomas in contrast to hidradenomas is the lack of myoepithelial cells. In addition, it is very difficult to differentiate middle ear adenoma and adenocarcinoma using histopathological and clinical methods. Therefore, thorough follow-up is mandatory for patients after surgical treatment of middle ear adenomas.
中耳腺瘤是起源于中耳黏膜的罕见良性腺性肿瘤。在分别于25年前和15年前进行过手术之后,一名67岁女性出现头晕、耳鸣和左侧单侧听力丧失的症状。耳镜检查发现鼓室内有一个肿瘤,该肿瘤得以完全切除。组织学检查显示为伴有胆脂瘤的中耳腺瘤。这与1983年那次手术的组织学结果不一致,当时那次手术的结果描述为大汗腺腺瘤。对切片的精确分析证实1983年时就已存在中耳腺瘤。大汗腺腺瘤是最重要的鉴别诊断之一。与大汗腺腺瘤相比,中耳腺瘤的特征性组织学表现是缺乏肌上皮细胞。此外,使用组织病理学和临床方法很难区分中耳腺瘤和腺癌。因此,中耳腺瘤手术治疗后的患者必须进行全面随访。