Malakoplakia of the temporal bone in a nine-month-old infant

Abstract

A case of malakoplakia, of the temporal bone in a nine-month-old male child is reported.The lesion presented as an aural polyp, associated with a lower motor neuron facial palsy. On exploration, the granuloma was noted to involve the temporal bone, eroding the bony labyrinth. It was successfully treated with surgical debridement, and antibiotics. A review of the relevant literature is presented.

Malakoplakia of Bone

“…This observation suggests that a foreign glycolipid material, possibly of E. coli origin, may play an etiologic role. Immunosuppression also appears to be associated with malakoplakia and was present in four of the nine cases involving bone 12,13,[15][16][17][18][19][20] .…”

“…The radiographic appearance is usually that of a permeative lesion and, often, a pathologic fracture 12,13,[15][16][17][18][19][20] . For the treating surgeon, the finding of edema on MRI can be suggestive of a pathologic process such as infection or neoplasm.…”

“…In these instances, biopsy and culture may be needed. Treatment of malakoplakia of bone is favorable when surgery is paired with antibiotics that have good intracellular penetration 12,13,[15][16][17][18][19][20] . Although malakoplakia involving bone is rare, surgeons and pathologists should be aware that it can present as a mass-like lytic lesion.…”

Malakoplakia of Bone

“…2 Only an occasional case of malakoplakia affecting the temporal bone has been reported in an infant. 4 Though the lesion may involve almost any body site, 3 it is found most commonly in the urinary tract. 8 Bone is only rarely affected, presenting as a lytic lesion or pathologic fracture.…”

“…To the best of our knowledge, only five cases have been reported to date. 4,9 Case Report A 3-year-old male presented with a tender swelling in the left gluteal region that had existed for one month. There was no history of trauma, tuberculosis, urinary complaints, recent infections or vaccination.…”