Primary Lymphoma of the Temporal Bone: The First Locally Reported Case

Abstract

Objective: To report a case of primary non-Hodgkin’s T-cell lymphoma in the temporal bone in a pediatric patient, discussing clinical presentation and course, diagnostic evaluation and management in the light of published literature. 
 Methods:
 Design: Case report
 Setting: Private tertiary university hospital
 Patient: One
 Results: An 8-year-old female with a 10-month history of otalgia and ipsilateral headache developed facial paralysis, unresponsive to topical otic drops and oral antibiotics. Imaging revealed mastoid sclerosis, tegmental and ossicular erosions, and an attico-antral mass which was excised through exploratory tympanomastoidectomy. Final histopath following immunohistochemical corroboration was T-cell lymphoma.
 Conclusion: Primary malignant lymphoma of the temporal bone may initially present with otalgia and headache unresponsive to conventional medical management. Ominous signs like facial paralysis should heighten the suspicion of malignancy warranting prompt imaging of the temporal bone. Histopathologic evaluation of all mastoidectomy specimens should be mandatory especially in children, and special stains performed as needed. Patients with T cell NHL should undergo chemotherapy and may warrant closer follow up for tumor recurrence and disease progression. 
 Keywords: non-Hodgkin's lymphoma, Temporal bone