Ayadi Sirine, Walha Omar, Kharrat Rania, Ben Ayed Mariem, Hammami Boutheina, Chaabouni Mohamed Amine, Charfeddine Ilhem
ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Faculty of Medicine of Sfax, Tunisia.
SAGE Open Med Case Rep. 2024 May 31;12:2050313X241258155. doi: 10.1177/2050313X241258155. eCollection 2024.
This report presents a rare case of bronchogenic adenocarcinoma with initial metastasis in the external auditory canal. The patient, a 64-year-old man with a history of bladder urothelial carcinoma, initially presented with a persistent right otitis externa. Otoscopic examination revealed a mass obstructing the right external auditory canal. The temporal bone computed tomography scan revealed a mass that completely obstructed the right external auditory canal and extended into the middle ear. A biopsy showed a poorly differentiated adenocarcinoma of bronchogenic origin, confirmed by positive immunohistochemical staining for cytokeratin 7 and Thyroid transcription factor-1. Further imaging revealed a large tumor mass in the lung involving the mediastinum and parenchyma, along with carcinomatous lymphangitis and cerebral metastasis. Histopathological examination of the primary lung tumor confirmed a poorly differentiated adenocarcinoma with similar features to the metastasis in the external auditory canal. The tumor was staged as T4N2M1c, and the patient underwent local external-beam radiation therapy with chemotherapy.
本报告介绍了一例罕见的支气管源性腺癌，最初转移至外耳道。患者为一名64岁男性，有膀胱尿路上皮癌病史，最初表现为持续性右外耳道炎。耳镜检查发现有肿物阻塞右外耳道。颞骨计算机断层扫描显示肿物完全阻塞右外耳道并延伸至中耳。活检显示为支气管源性低分化腺癌，细胞角蛋白7和甲状腺转录因子-1免疫组化染色阳性得以证实。进一步影像学检查显示肺部有一个巨大肿瘤肿块，累及纵隔和实质，伴有癌性淋巴管炎和脑转移。对原发性肺肿瘤的组织病理学检查证实为低分化腺癌，其特征与外耳道转移瘤相似。肿瘤分期为T4N2M1c，患者接受了局部外照射放疗及化疗。
