Wang Fangyuan, Wu Nan, Hou Zhaohui, Liu Jun, Shen Weidong, Han Weiju, Yang Shiming
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1438-42.
To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal.
Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed.
There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later.
Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
分析外耳道罕见恶性肿瘤的诊断、治疗及预后情况。
收集除鳞状细胞癌和腺样囊性癌外的8例外耳道罕见恶性肿瘤病例，分析其临床表现、分期、手术方式、后续治疗及预后情况。
其中基底细胞癌5例，黏液表皮样癌2例，肌上皮癌1例。5例外耳道基底细胞癌中有3例曾长期误诊。入院后，5例基底细胞癌中4例为T1期，仅通过肿瘤完整切除治愈。1例T2期基底细胞癌在首次肿瘤切除术后2年复发，接受放疗后肿瘤得到控制。2例黏液表皮样癌曾被误诊为良性肿瘤并接受了切除术。1例出现咽旁间隙和鼻咽部转移，接受同步化疗，5年随访后肿瘤也得到控制。另1例出现腮腺转移，接受扩大肿瘤切除术，1年随访后未发现复发。1例外耳道T4期肌上皮癌为腮腺转移，接受了部分颞骨切除术，1年后未发现复发。
由于上述肿瘤在外耳道发病率极低且肿瘤位置隐蔽，常被误诊并延误治疗。因此，耳科医生应更加注意避免误诊。对于治疗，早期肿瘤完整手术切除很重要，晚期肿瘤可能需要辅以放化疗。
