Song Kunho, Park Ki-Wan, Heo Jae-Hyung, Song Ik-Chan, Park Yong-Ho, Choi Jin Woong
Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
Clin Exp Otorhinolaryngol. 2019 Feb;12(1):27-32. doi: 10.21053/ceo.2018.00171. Epub 2018 Jun 19.
The purpose of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy.
We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups.
The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively).
If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do.
本研究旨在评估颞骨转移瘤（TBM）的临床特征，并确定这些特征是否因原发恶性肿瘤而异。
我们回顾性分析了2000年1月至2017年1月期间诊断为TBM的20例患者的数据。评估了人口统计学资料、从原发恶性肿瘤诊断到TBM诊断的时间、从TBM诊断到死亡的时间、原发恶性肿瘤的类型和分期、耳科表现以及TBM部位。在将原发恶性肿瘤分为实体癌和血液系统恶性肿瘤后，对两组之间的每个参数进行了比较。
TBM最常见的原发恶性肿瘤是肺癌（45%）。最常见的耳科症状和体征是面瘫（30.5%）和听力损失（30.5%）。颞鳞部（23%）和面神经（20%）是最常受累的部位。大多数TBM发生在疾病过程后期，即在原发恶性肿瘤首次转移到其他器官之后。与实体癌相比，血液系统恶性肿瘤转移至外耳道和中耳/乳突的频率明显更高（分别为P = 0.001和P = 0.004）。
如果恶性肿瘤晚期患者出现面瘫和听力损失等耳科表现，应怀疑存在原发恶性肿瘤的TBM。此外，血液系统恶性肿瘤比实体癌更倾向于转移至外耳道和中耳裂。
