Wang Jianyan, Liu Danqing, Meng Yingdi, Guo Yingyuan, Zhao Ming
Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Department of Otorhinolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
J Int Med Res. 2020 Aug;48(8):300060520946517. doi: 10.1177/0300060520946517.
Extrapulmonary small cell carcinoma (EPSCC) affecting the external auditory canal (EAC) is uncommon. We herein report a case involving a 56-year-old man with EPSCC of the EAC who had a 48-year history of recurrent purulent discharge in both ears and a 20-day history of right ear pain and hemorrhage followed by incomplete right eyelid closure and an askew mouth. He underwent surgical removal of middle ear granulation tissue, residual ossicles, and a right EAC mass. Postoperatively, pathomorphological examination combined with immunohistochemical staining supported a diagnosis of small cell carcinoma. Radiation therapy at a dose of 60.06 Gy in 33 daily fractions was completed 1 month after surgery, and synchronous etoposide-cisplatin regimen chemotherapy was performed for two cycles and four sequential cycles. One year postoperatively, magnetic resonance imaging showed no tumor in the ear; however, computed tomography showed multiple liver space-occupying lesions that were considered to indicate liver metastasis. Further chemotherapy was performed, but the patient died 15 months postoperatively. This case indicates that timely and accurate chemoradiotherapy is likely the most reasonable approach to EPSCC of the EAC given the aggressiveness of this tumor.
累及外耳道（EAC）的肺外小细胞癌（EPSCC）并不常见。我们在此报告一例病例，患者为一名56岁男性，患有EAC的EPSCC，双耳反复脓性分泌物有48年病史，右耳疼痛和出血20天，随后出现右眼睑闭合不全和口角歪斜。他接受了中耳肉芽组织、残留听小骨和右侧EAC肿物的手术切除。术后，病理形态学检查结合免疫组化染色支持小细胞癌的诊断。术后1个月完成了剂量为60.06 Gy、分33次每日照射的放射治疗，并进行了同步依托泊苷-顺铂方案化疗两个周期以及四个序贯周期。术后1年，磁共振成像显示耳部无肿瘤；然而，计算机断层扫描显示肝脏有多个占位性病变，考虑为肝转移。进一步进行了化疗，但患者术后15个月死亡。该病例表明，鉴于这种肿瘤的侵袭性，及时、准确的放化疗可能是EAC的EPSCC最合理的治疗方法。
