Konishi Masaya, Suzuki Kensuke, Iwai Hiroshi
Department of Otolaryngology-Head and Neck Surgery, Kansai Medical University, Osaka, Japan.
Case Rep Oncol. 2017 Feb 24;10(1):212-216. doi: 10.1159/000460243. eCollection 2017 Jan-Apr.
Metastatic renal cell carcinoma (RCC) involving the temporal bone is a rare entity. It is usually asymptomatic and misdiagnosis as acute otitis media, mastoiditis, and Ramsay-Hunt syndrome in early onset is not uncommon. We report a case of RCC metastasis to the postoperative temporal bone in the middle of molecular targeted therapy. A 60-year-old man presented left facial palsy with severe retro-auricular pain and he also underwent left middle ear surgery for cholesteatoma more than 30 years before and had been aware of discontinuous otorrhea; therefore, initially we speculated that facial palsy was derived from recurrent cholesteatoma or Ramsay-Hunt syndrome. Exploratory tympanotomy revealed RCC metastasis and postoperative MR indicated hematogenous metastasis. To the best of our knowledge, no report was obtained on temporal bone metastasis in the middle of chemotherapy or hematogenous metastasis in the postoperative middle ear. Metastasis in the temporal bone is still a possible pathological condition despite the development of present cancer therapy. Besides, this case indicates that hematogenous metastasis can occur in the postoperative state of the temporal bone.
转移性肾细胞癌（RCC）累及颞骨是一种罕见的情况。它通常无症状，在发病早期被误诊为急性中耳炎、乳突炎和拉姆齐-亨特综合征的情况并不少见。我们报告一例在分子靶向治疗中期发生RCC转移至术后颞骨的病例。一名60岁男性出现左侧面神经麻痹并伴有严重耳后疼痛，他在30多年前曾因胆脂瘤接受过左耳中耳手术，且一直有间断性耳漏；因此，最初我们推测面神经麻痹源于复发性胆脂瘤或拉姆齐-亨特综合征。探查性鼓室切开术显示为RCC转移，术后磁共振成像（MR）提示血行转移。据我们所知，尚无关于化疗中期颞骨转移或术后中耳血行转移的报道。尽管目前癌症治疗有所发展，但颞骨转移仍是一种可能的病理状况。此外，该病例表明血行转移可发生在颞骨术后状态。
