Squamous Cell Carcinoma of the Middle Ear Mimicking CSOM with Intracranial Complications: A Diagnostic Dilemma

Abstract

Cancer of the external auditory canal (EAC) and middle ear (ME) is rare, accounting for less than 1% of all head-and-neck malignancies [1] [2] of which squamous cell carcinoma (SCC) is the most common. Even though squamous cell carcinoma [SCC] of the middle ear and chronic suppurative otitis media (CSOM) co-exist, no definitive correlation has been proven. Here we are presenting a case of squamous cell carcinoma of the middle ear who presented with headache, fever and vomiting with a background history of chronic suppurative otitis media since childhood. A provisional diagnosis of mastoid abscess with intracranial complications secondary to chronic suppurative otitis media was made and modified radical mastoidectomy was done but histology of the mastoid specimen revealed well differentiated keratinizing squamous cell carcinoma, which was treated with radical radiotherapy. Objective of this presentation is to bring attention to the coexistence of CSOM and squamous cell carcinoma ear and also the importance to detect these lesions at an early stage. This report also highlights the requirement of histopathological analysis in mastoidectomy and discusses the aetiology and management of squamous cell carcinoma of the middle ear with review of literature.