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Carcinoma arising in or about the eustachian tube, without involving the mucous membrane of the nasopharynx, is an uncommon condition, which presents difficult diagnostic and therapeutic problems, and apparently bears a very bad prognosis. Brief examination of the recent literature disclosed about six pertinent articles in the foreign literature, particularly in Italian, and none in English or American literature.During the past four years, two cases of carcinoma of the eustachian tube have been studied on the otology service of Furstenberg, at the University of Michigan. In one case, the site of the primary lesion was suspected, but not proved until autopsy. In the second case, the malignancy was totally unsuspected clinically and demonstrated only on postmortem examination.The first patient was a 33 -year-old Russian Jew (H. S.), who was first seen on May 6th, 1936. In September, 1935, he first noticed deafness and tinnitus in the right ear, associated with right occipital headache. Swelling in the right side of the neck just below the mastoid tip appeared in December, 1935.On examination the right canal was normal, and the membrane was dull, not abnormally full, and without landmarks. There was a slight conductive deafness. The left ear appeared normal. The nasal septum was fairly straight, with an adequate breathing space. The throat and larynx were normal. It was never possible to do a satisfactory mirror examination of the nasopharynx because of poor cooperation on the part of the patient. Palpation raised the question of a small flat nodule in the right fossa of Rosenmiiller. There was a large, non-tender, homogeneous swelling of the right side of the neck covering the sternomastoid muscle and extending into the posterior triangle. Two biopsies of the suspected area in the nasopharynx showed only lymphoid tissue without carcinoma. A biopsy of the mass in the neck showed a poorly differentiated squamous cell carcinoma. Roentgen studies revealed clouding of the right masat The University of Iowa Libraries on June 21, 2015 aor.sagepub.com Downloaded from

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