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Trimodality approach for ceruminous mucoepidermoid carcinoma of the external auditory canal

Published online by Cambridge University Press:  15 January 2013

W F Mourad ,
K S Hu ,
R A Shourbaji  and
L B Harrison
W F Mourad*
Affiliation:
Department of Radiation Oncology, Beth Israel Medical Center, New York, USA Department of Radiation Oncology, Albert Einstein College of Medicine, New York, USA
K S Hu
Affiliation:
Department of Radiation Oncology, Beth Israel Medical Center, New York, USA
R A Shourbaji
Affiliation:
Department of Radiation Oncology, Beth Israel Medical Center, New York, USA
L B Harrison
Affiliation:
Department of Radiation Oncology, Beth Israel Medical Center, New York, USA
*
Address for correspondence: Dr W F Mourad, 10 Union Square East, Suite 4G, New York, NY 10003, USA Fax: +1 212 844 8086 E-mail: [email protected]
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Abstract

Background:

Ceruminous mucoepidermoid carcinoma of the external auditory canal is extremely rare. This paper highlights the impact of concurrent chemoradiotherapy on the outcomes of this disease.

Case report:

A 47-year-old female presented with a 2-month history of otalgia and a mass in her right ear. Biopsy revealed high grade ceruminous mucoepidermoid carcinoma. She underwent surgical excision of the right external auditory canal and right upper neck dissection. Pathological analysis of tumour–node–metastasis staging revealed a T2 N0 (stage II) tumour. One year later, computed tomography scanning of the temporal bone showed tumour recurrence. Biopsy revealed recurrent ceruminous mucoepidermoid carcinoma. The patient underwent salvage resection. Pathology revealed that the tumour was diffusely invading nearby structures, with perineural invasion, lymphatic spread and extracapsular extension. Pathological analysis of tumour–node–metastasis staging revealed a T3 N1 M0 (recurrent stage IV) tumour.

Results:

The patient subsequently received concurrent chemoradiotherapy. There was no evidence of disease at 37 months' follow up.

Conclusion:

The trimodality approach, using surgery plus concurrent chemoradiotherapy, provided reasonable loco-regional control with tolerable toxicity. Further detailed case reports are warranted to optimise the management of this rare malignancy.

Keywords

External Auditory CanalMucoepidermoid CarcinomaCerumenOtologic Surgical ProceduresPathologyChemoradiotherapy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 2 , February 2013 , pp. 203 - 206
Copyright
Copyright © JLO (1984) Limited 2013

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