Злокачественные опухоли наружного и среднего уха

Abstract

It is described the clinical case of a 38-year-old patient with concomitant psoriatic arthritis. He was directed to the Otolaryngology department of Ulyanovsk Regional Clinical Hospital with a diagnosis of Acute bilateral perforated purulent otitis media complicated by external one. Parotid left lymphadenitis. . In the medical history: the first treatment with complaints of pain in the left ear in March 2019, received treatment, there was a positive change. Return visit in October 2019. In connection with the deterioration of his condition, he was sent to the Ulyanovsk Regional Clinical Hospital. Upon admission, he complained of discharge from the left ear, aching pain in the ear, headache, the presence of a tumor-like formation in the lateral surface of the neck on the left, facial asymmetry, intense pain in the right ear, bloody discharge from the right ear canal, presence of formation at the entrance in the right ear canal, weakness, dry mouth. The results of computed tomography and X-ray studies of the mastoid processes according to Schuller showed signs of a destructive process in the region of the temporal, sphenoid bones, and the mastoid process on the left. An ultrasound of the soft tissues of the neck on the left revealed fluid formation and an altered lymph node in the submandibular region. The extended radical surgery on the left ear with mastoidotomy was done to the patient. It was performed lancing of the abscess of lymph nodes of the neck on the left. It was done a biopsy of various sections of the middle and outer ear on the left intraoperatively and the formation of the external ear canal on the right. According to the results of a histological examination it was revealed the growth of squamous cell carcinoma in the external ear canal and middle ear on the left, in the ear canal on the right. After a consultation at the Regional Clinical Oncology Center, the following diagnosis was made: “Cancer of the mucous membrane of the middle ear of the left in stage IV (T4N1M0). External ear cancer on the right in stage IV (T4N0M0). Type II diabetes mellitus. Psoriatic polyarthritis. It was recommended chemoradiation treatment. Thus, we observed a bilateral malignant process in the ear the first time over many years.