A rare case of metachronous triple cancers involving the tympanic membrane

Hui-Yu Chang,Fang Zhou,Hua Jiang

doi:10.12669/pjms.291.2490

Abstract

Multiple primary malignancies are not rare. While metachronous triple cancers are rare and a triple tumor case involving maxillary sinus and tympanic membrane is exceptionally rare. We present such an extremely rare case with the index tumor of adenoid cystic carcinoma of the maxillary sinus and 14 years later esophageal cancer was observed as a metachronous tumor. One year after esophageal cancer, squamous cell carcinoma arising from tympanic membrane was detected. Before the tumor of tympanic membrane was observed, the patient had received total three radiation courses. Prior radiation therapy is suspected to be playing a role in inducing the squamous cell carcinoma of the tympanic membrane.

Highlights

A case involving the tympanic membrane is very rare. We present such an extremely rare triple primary tumor case with the index tumor of adenoid cystic carcinoma (ACC) of maxillary sinus and two metachronous tumors of squamous cell carcinomas (SCC) of tympanic membrane and esophagus
Most primary malignant tumors arising in the paranasal sinus are SCC
Because of late detection owing to sinusitis-like symptoms and relative surgical inaccessibility owing to important adjacent structures, maxillary ACC is recognized to have a unfavorable prognosis.[2,3]

Summary

INTRODUCTION

A case involving the tympanic membrane is very rare We present such an extremely rare triple primary tumor case with the index tumor of adenoid cystic carcinoma (ACC) of maxillary sinus and two metachronous tumors of squamous cell carcinomas (SCC) of tympanic membrane and esophagus. Malignant change of the papilloma was found by histologic examination and a diagnosis of SCC was made. Examination revealed a tumor mass arising from tympanic membrane in the right external auditory canal. No signs of either local tumor recurrence or distant metastases were found on review at twenty-two months. It is the second metachronous tumor in the patient. After that, during the 15year follow-up period, no recurrence or metastases were observed

DISCUSSION

Findings

Metachronous triple cancers