Gut S M, Wagner B, Kessler M, Linder T
Klinik für Hals-Nasen-Ohren-, Hals- und Gesichtschirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Luzern 16, Schweiz,
HNO. 2014 Mar;62(3):180, 182-5. doi: 10.1007/s00106-013-2800-6.
Neuroendocrine adenomas of the middle ear are rare, low-grade neoplasms with potential for recurrence and metastasis. The nonspecific symptoms and preliminary clinical and radiological findings are misleading and often fail to provide the right diagnosis.
We analyzed the findings of 3 adult patients, who were treated between 2001 and June /2012 at the Luzerner Kantonsspital in Switzerland.
The 3 patients reported on hearing loss, ear pressure and/or tinnitus. Otoscopy showed a thickened, intact tympanic membrane with a whitish-grayish prolapsing mass. All the patients had conductive hearing loss. Computer tomography showed an unspecified well-circumscribed soft-tissue mass. Definitive histology with immunostaining after radical tumor removal led to the proper diagnosis.
The typical constellation of nonspecific clinical and radiological findings leads to the right diagnosis of neuroendocrine adenoma of the middle ear. After reviewing the literature, we illustrate the differential diagnosis as well as the relevant diagnostic and therapeutic procedures, and remind ENT physicians about this rare disease entity.
中耳神经内分泌腺瘤是罕见的低度肿瘤，有复发和转移的可能。非特异性症状以及初步的临床和影像学检查结果具有误导性，常常无法提供正确诊断。
我们分析了2001年至2012年6月期间在瑞士卢塞恩州立医院接受治疗的3例成年患者的检查结果。
3例患者均报告有听力损失、耳内闷胀感和/或耳鸣。耳镜检查显示鼓膜增厚、完整，有灰白色突出肿物。所有患者均有传导性听力损失。计算机断层扫描显示有一个边界清晰的未明确软组织肿物。肿瘤根治性切除后进行的确定性组织学检查及免疫染色确诊了病情。
非特异性临床和影像学检查结果的典型组合有助于正确诊断中耳神经内分泌腺瘤。在查阅文献后，我们阐述了鉴别诊断以及相关的诊断和治疗程序，并提醒耳鼻喉科医生注意这种罕见的疾病实体。
