Lasisi Oa, Ogunleye Ao, Akang Eeu
Departments of Otorhinolaryngology and Pathology, University of Ibadan, P.O. Box 22040, Ibadan, Nigeria.
Ghana Med J. 2005 Mar;39(1):28-32. doi: 10.4314/gmj.v39i1.35978.
SummaryMalignant tumours of the mastoid are rare, the majority being squamous cell carcinomas. We report two cases whose clinical presentation mimicked mastoid abscess with intracranial complications. The first case is a twenty year Nigerian lady who presented to the Emergency Room of the Otorhinolaryngology Department with a one month history of headache, low grade fever, left facial palsy, neck stiffness and left post-auricular swelling on a background of left chronic suppurative otitis media since childhood. An initial diagnosis of meningitis and mastoid abscess secondary to chronic suppurative otitis media was made but histology of the mastoid specimen revealed keratinizing squamous cell carcinoma, which was treated with palliative primary radiotherapy. The second case is a 45-year old man with a chronic mastoiditis and mastoid abscess that was later found to be suamous cell carcinoma of the mastoid and was managed with combination of surgery and radiotherapy. The report highlights advanced stage of the disease at presentation, and discusses the etiology and management. To the best of our knowledge, these are the first cases of this entity to be documented in Africans.
摘要
乳突恶性肿瘤较为罕见，大多数为鳞状细胞癌。我们报告两例临床表现类似乳突脓肿并伴有颅内并发症的病例。第一例是一名20岁的尼日利亚女性，因自幼患有左侧慢性化脓性中耳炎，出现头痛、低热、左侧面瘫、颈部僵硬和左耳后肿胀一个月，就诊于耳鼻喉科急诊室。最初诊断为慢性化脓性中耳炎继发脑膜炎和乳突脓肿，但乳突标本的组织学检查显示为角化性鳞状细胞癌，采用姑息性原发灶放疗进行治疗。第二例是一名45岁男性，患有慢性乳突炎和乳突脓肿，后来发现是乳突鳞状细胞癌，采用手术和放疗联合治疗。该报告强调了疾病呈现时的晚期阶段，并讨论了病因和治疗方法。据我们所知，这是非洲首次记录的此类病例。
