Carcinoma Of Temporal Bone Research Articles

Squamous cell carcinoma of ear and temporal bone: A retrospective study on clinicopathological predictors.

Ear and temporal bone squamous cell carcinoma (ETBSCC) is a rare and aggressive malignant tumor with minimal clinicopathological studies. The object of this study was to retrospectively evaluate the predictive effect of clinicopathological variables on the 5-year overall survival (OS) rate of ETBSCC patients in a single tertiary medical center in Tianjin, China. A cohort of 44 patients with diagnosed ETBSCC from December 2012 to August 2022 were retrospectively studied. Univariate and multivariate analysis were, respectively, performed for the assessment of clinicopathological predictors, including sex, age, history of chronic suppurative otitis media (CSOM), lesion side, diameter, the choice of surgical approach, parotidectomy, neck dissection, adjuvant therapies, T stage, lymph node metastasis, tumor grade, margin, perineural invasion (PNI), and Ki-67 index. Seventeen females and 27 males were included, with the mean age of 65 years old, ranging from 36 to 89 years. The 5-year OS rate was 43% (mean 51 months, 95% confidence interval [CI] = 39-64). Significant prediction of a worse prognosis for 5-year OS rate was observed under univariate analysis for advanced T stage, positive margin, identified PNI, and higher Ki-67 index, respectively. Advanced T stage was confirmed to be an independent prognostic factor strongly affecting 5-year OS rate among this cohort of patients using a multivariate cox proportional hazard model. We found that clinicopathological parameters, especially postoperative pathological parameters, play a critical role in predicting the prognosis of ETBSCC patients.

Temporal bone carcinoma: testing the prognostic value of a novel clinical and histological scoring system.

Our group recently proposed thenovel Padova prognostic scoring system for temporal bone carcinoma (TBSCC) that considers: the revised Pittsburgh staging system; radiological dura mater involvement; non-anterior spread (medial, inferior orposterior into the temporal bone and skull base) of T4 tumors; and histological grade. The aim of the present study was to validate this prognostic TBSCC scoring system in a case series selected from the literature. A search was run to identify studies on TBSCC reporting the variables included in our score for each patient. Then our system was applied to the data extracted. Only two published investigations reported all the clinical and pathological data required for our scoring system. In one series from the Gruppo Otologico in Piacenza (Italy), a significantly higher recurrence rate (p = 0.008), shorter disease-free survival (DFS) (p = 0.001), higher disease-specific mortality (DSM) (p = 0.006), and shorter disease-specific survival (DSS) (p = 0.004) were associated with scores ≥ 5. Receiver operating curve (ROC) analysis showed an AUC of 0.804 for TBSCC recurrence, and 0.832 for DSM. In a series from Kyushu University Hospital (Japan), a significantly higher DSM (p = 0.018) and shorter DSS (p = 0.021) were associated with scores ≥ 5. ROC analysis showed an AUC of 0.812 for tumor relapse and 0.790 for DSM. Our TBSCCPadova scoring system confirmed its validity when applied to the only two international TBSCC series providing the required data. These preliminary results need to be confirmed in a multi-center prospective setting.

Squamous Cell Carcinoma of Temporal Bone after Brain Tumor Treatment: A Tricky Diagnosis of a Late Radiotherapy Complication

Primary cancer of the External Auditory Meatus (EAM) is a rare disease, with squamous cell carcinoma (SCC) being the most frequent histological type. The invasion of local tissues occurs in most cases, and its treatment is a challenge due to the complex local anatomy. This report presents the case of a 40-year-old patient who presented with a complaint of chronic otorrhea associated with a mass in EAM and a history of treatment of posterior fossa astrocytoma 17 years ago, treated with neurosurgery followed by radiotherapy.

Temporal bone carcinoma: Novel prognostic score based on clinical and histological features

This study aimed to develop a novel temporal bone squamous cell carcinoma (TBSCC) prognosis scoring system and compare it with the revised Pittsburgh staging system. Forty-four consecutive TBSCC patients were assessed to identify predictors of recurrence. Each predictor's hazard ratio for recurrence was used to develop our novel scoring system. Based on variables with P < .10 in Cox's regression model, our score included: revised Pittsburgh stage; non-anterior spread of T4 carcinoma; dural involvement; and histological grade. A higher recurrence rate (P = .000) and shorter disease-free survival (P = .000) were associated with scores of ≥5. The area under the curve of our score was larger than that of the revised Pittsburgh stage for both recurrence and disease-specific mortality (P = .0178 and P = .0193, respectively). Our TBSCC scoring system is based on variables that are obtainable preoperatively from clinical and radiological data and biopsies. Its prognostic value should be validated for published TBSCC series and then in prospective settings.

Temporal bone carcinoma: Treatment patterns and survival.

Carcinomas of the temporal bone are rare, and appropriate treatment, staging, and survival data are limited. This study evaluates clinical characteristics and survival rates for patients with temporal bone carcinoma treated with resection at a single tertiary-care institution, with a focus on the outcomes of patients with locally advanced disease including skull base and/or dural invasion. Retrospective chart review. Demographic, tumor-specific, and survival data were collected for patients with primary carcinomas of the external auditory canal with involvement of the temporal bone from 2003 to 2015. All patients were staged according to the modified Pittsburgh system. Kaplan-Meier and logistic regression analysis were used to calculate factor-specific survival outcomes. Sixty-seven patients met inclusion criteria; 85% were male. There were 43 squamous cell carcinomas (64%) and 24 basal cell carcinomas (BCCs) (36%). Tumor stage was 24 (36%) T2, 12 (18%) T3, and 31 (46%) T4 tumors; 53% had recurrent disease. Surgical management included 49 lateral temporal bone resections and 18 subtotal temporal bone resections. Kaplan-Meier analyses revealed more favorable 5-year survival rates associated with BCC histology (P = .01), lateral temporal bone resection compared to subtotal temporal bone resection (P < .01), lack of immunocompromise (P = .04), and absence of perineural/lymphovascular invasion (P = .01). Multivariate regression analysis did not yield statistically significant results. Factors predictive of more favorable survival include lack of immunocompromise, BCC histology, absence of perineural/lymphovascular invasion, and disease extent amenable to lateral temporal bone resection. Dural invasion is not an absolute contraindication to surgery, with a subset of patients surviving >5 years. 3 Laryngoscope, 130:E11-E20, 2020.

Update in Temporal Bone Resection Outcomes

Surgical outcomes data related to temporal bone malignancy can be challenging to interpret and apply to a specific patient population due to the overall rarity of the disease and the heterogeneity of disease types often studied in aggregate in this anatomic region. Large institutional series are commonly composed of a diverse patient cohort, with numerous pathologic entities studied in aggregate despite known differences in biologic behavior. Our current aim is to provide a review of recent literature on surgical resection of primary, untreated squamous cell carcinoma of the temporal bone and examine associated outcomes. A general overview of temporal bone carcinoma and illustrated, contemporary update of surgical techniques is additionally provided.

Otologic presentation of multiple myeloma with isolated temporal bone involvement: Diagnostic and therapeutic implications

Plasma cell disorder spectrum ranges from the benign plasma cell granuloma to malignant multiple myeloma characterized by the monoclonal proliferation of plasma cells. Multiple myeloma with temporal bone involvement is a rare entity and may present with nonspecific otological symptoms similar to chronic ear disease leading to a diagnostic challenge. Suspicion of multiple myeloma involving temporal bone primarily is difficult, and most of the cases are diagnosed after initial surgical excision. The differential diagnosis includes temporal bone carcinoma and glomus tumor due to similar radiological features. The final diagnosis is, however, made by the histopathological and immunohistochemical analysis. The mainstay of treatment of multiple myeloma is chemotherapy; however, surgical excision of the lesion is warranted in cases of pressure symptoms and intracranial involvement. We present a case who presented with ear canal mass, facial palsy, and cerebellar symptoms and was diagnosed to be a case of multiple myeloma with temporal bone involvement and was treated successfully. He is on regular follow-up for 1 year and remains in complete remission.

Management of Stage IV Carcinoma of Temporal Bone: Institutional Experience

Management of Stage IV Carcinoma of Temporal Bone: Institutional Experience

Cortactin and phosphorylated cortactin tyr466 expression in temporal bone carcinoma

PurposeCortactin is a multidomain protein engaged in several cellular mechanisms involving actin assembly and cytoskeletal arrangement. Cortactin overexpression in several malignancies has been associated with increased cell migration, invasion, and metastatic potential. Cortactin needs to be activated by tyrosine or serine/threonine phosphorylation. The role of cortactin and phosphorylated cortactin (residue tyr466) was investigated in temporal bone squamous cell carcinoma (TBSCC). Materials and methodsImmunohistochemical expression of cortactin and phosphorylated cortactin (residue tyr466) was assessed in 27 consecutively-operated TBSCCs. ResultsSeveral clinicopathological variables correlated with recurrence (pT stage, dura mater involvement), and disease-free survival (DFS) (cT stage, pT stage, pN status, dura mater involvement). Twenty-three of 24 immunohistochemically evaluable TBSCCs were cortactin-positive. Median cortactin expression was 75.0%. Cortactin reaction in the cytoplasm was more intense in carcinoma cells than in normal adjacent tissue. Recurrence and DFS rates did not correlate with cortactin and phosphorylated cortactin (residue tyr466) expression in TBSCC specimens. ConclusionsCortactin upregulation in TBSCC supports the conviction that inhibiting cortactin functions could have selective effects on this malignancy. Multi-institutional studies should further investigate the role of cortactin and phosphorylated cortactin in TBSCC, and their potential clinical application in integrated treatment modalities.

Diagnostic dilemma in a case of temporal bone carcinoma in a young man

Malignancy of temporal bone is a rare entity with an incidence of <0.2% of all head-and-neck cancer with an average age of occurrence at 60 years. We present here a case of a 21-year-old boy with temporal bone cancer who presented with clinical features of complicated chronic suppurative otitis media, radiologically as chronic osteomyelitis creating a diagnostic dilemma as there was no predisposing factor for osteomyelitis. The diagnosis was confirmed by open biopsy which revealed squamous cell carcinoma. The best survival rate is obtained with total temporal bone resection and post-operative radiotherapy.

Temporal bone carcinoma: a first glance beyond the conventional clinical and pathological prognostic factors

Temporal bone squamous cell carcinoma (TBSCC) is an uncommon, aggressive malignancy with a poor prognosis in advanced cases. The dismal outcome is partially related to: the lack of reliable clinical or pathological prognostic factors and the largely unstandardized surgical and integrated treatments adopted. There is an undeniable need for novel diagnostic/therapeutic strategies to improve the prognosis. The purpose of this critical review was to explore the level of available knowledge concerning the molecular markers involved in the biology of TBSCC that have a prognostic potential. The Pub-Med and Scopus electronic databases were searched without publication date limits for studies investigating molecular markers in cohorts of patients with primary TBSCC. The search terms used were: "temporal bone cancer", "temporal bone carcinoma", "temporal bone malignancy", "ear cancer", "ear carcinoma", and "ear malignancy". We decided preliminarily not to consider series with less than five cases. Nine retrospective case series of TBSCC were found in which different analytical techniques had been used to study the role of several biomarkers (HPV, vimentin, transforming growth factor β, CD105, RECK, matrix metalloproteinase-9, MASPIN, EBV, p16, TP53 mutation, pSTAT3, relaxin-2). CD105 expression (in tumor vessel endothelial cells) and MASPIN cytoplasmic expression (in carcinoma cells) were, respectively, found directly and inversely related with the neoplasm's recurrence rate. CD105 expression was also inversely related with disease-free survival in TBSCC. A future goal of such analyses should be to ascertain the radio- and chemo-sensitivity profiles of individual TBSCCs, enabling truly personalized therapies. A further, more ambitious goal will be to find targets for therapeutic agents that might prove crucial in improving the disease-specific survival for patients with advanced TBSCC.

A critical look at persistent problems in the diagnosis, staging and treatment of temporal bone carcinoma.

Temporal bone squamous cell carcinoma (TBSCC) is an uncommon malignancy with a distinctly poor prognosis in advanced cases. There is still much controversy surrounding the rational diagnostic/therapeutic approach to TBSCC. Diagnostic differences are due mainly to: the small number of cases reported (even in the largest available series); the inappropriate histological heterogeneity of several case series; the lack of an internationally-accepted staging system for TBSCC; the frequent absence of adequate radiological imaging to enable a malignancy's local, regional and distant extension to be studied in detail; and a non-standardized approach to final histological assessment of the surgical margins. As for the therapeutic approaches, several issues are still debated, including the choice between en bloc and piecemeal primary surgery for the tumor's removal, and the role of elective neck dissection. Although radiotherapy seems to be an effective adjuvant therapy in advanced cases, its role in low-stage tumors or as a primary treatment has yet to be established. The value of chemotherapy is also still unclear. The treatment strategy for TBSCC is often based on the combined experience of a given surgeon and institution, bearing the results reportedly achieved by other oncology centers in mind. To date, the optimal management of TBSCC is still elusive. We aimed to critically review the ongoing crucial issues concerning the management of TBSCC, analyzing how it is diagnosed, staged and treated, the management of recurrences, rational follow-up schedules, and prognostic factors for this disease.

Clinical and pathological parameters prognostic for increased risk of recurrence after postoperative radiotherapy for temporal bone carcinoma.

Most authors agree that radical surgery for advanced, aggressive temporal bone squamous cell carcinoma (SCC) should be followed by postoperative radiotherapy (PORT). The purpose of this study was to identify clinical and/or conventional pathological parameters capable of pinpointing patients with temporal bone SCC at higher risk of recurrence after PORT. The investigation concerned 27 consecutive patients undergoing PORT for primary temporal bone SCC. Univariate statistics revealed a difference in the distributions for pT classification (p = .0004), pathological grade (p = .006), and dura mater involvement (p = .015) when patients were grouped by presence versus absence of recurrence after PORT. A panel of 3 parameters comprising pT classification (pT4), pathological grade (G2 or G3), and dura mater involvement demonstrated an outstanding discriminatory power (area under the curve [AUC] receiver operating characteristic [ROC] = 0.912) in predicting temporal bone SCC recurrence after PORT. The panel considered had an outstanding discriminatory power in pinpointing patients at higher risk of recurrence who could benefit from stricter follow-up protocols and postoperative chemoradiotherapy (CRT) for temporal bone SCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: 894-898, 2016.

Rare case study of a primary carcinoma of the petrous bone and a brief literature review

Temporal bone carcinoma is an aggressive tumor with multiple unconfirmed risk factors. Herein, we present a rare case of a primary petrous bone carcinoma in a female patient (65 years old) with an irrelevant medical history. She presented a postauricular swelling that revealed a multilocular osteolytic cystic lesion of the mastoid portion of the temporal bone on the CT scan. The patient underwent resection of the lesion and pathological analysis revealed moderately to well-differentiated squamous cell carcinoma. Postoperative radiotherapy was carried out. Until the present time, the patient shows complete remission on regular clinical and radiological follow-up. Although no widely accepted strategy for managing temporal bone tumors exists, a review of the literature showed that surgery with or without radiotherapy is the treatment of choice. Preoperative assessment and accurate staging are vital in ensuring that the treatment is adequate for each disease stage.

Magnetic Resonance Imaging versus Computed Tomography in Temporal Bone Carcinoma: Radiological and Pathological Correlation

Objectives: Correlate the findings of preoperative magnetic resonance imaging (MRI) and computed tomography (CT) in temporal bone carcinoma with histopathological findings following lateral temporal bone resection. Methods: In this retrospective review, 11 cases of temporal bone carcinoma over the past 3 years were reviewed at our institution. Preoperative CT and MRI scans were systematically reviewed for tumor involvement in 10 anatomic areas involving and surrounding the temporal bone. These were compared with results found on final histopathology. Results: Among the 11 cases, 30 anatomic areas of tumor involvement identified on CT imaging were also found on MRI and confirmed on final histopathology. Two areas suggestive on tumor involvement on CT and MRI (parotid gland and regional lymph nodes) and 2 areas on MRI alone (mastoid antrum and middle ear) were negative on final histopathology. MRI did not change the preoperative clinical staging in any of the 11 cases, however, examination of the MRI in 1 case suggested temporal lobe involvement that was not seen on CT images and subsequently changed the management of the patient. Conclusions: The addition of MRI in the preoperative evaluation of these patients confirmed the extent of tumor involvement seen on CT and did not identify additional tumor or facial nerve involvement in most cases except for one advanced case. In this case, the addition of the MRI findings changed the treatment plan. While CT remains the imaging gold-standard for preoperative evaluation and staging, MRI should be obtained in evaluating advanced temporal bone tumors.

Temporal bone carcinoma. Current diagnostic, therapeutic, and prognostic concepts.

Temporal bone carcinoma is an uncommon aggressive malignancy. Its low incidence and the absence of a globally accepted staging system still make it difficult to compare different centers' approaches and results. In this review of the main available studies dealing with temporal bone carcinoma since 1995, we consider its rational preoperative staging and assessment, compare the effectiveness of different treatments by tumor stage, and outline the main actuarial prognostic factors.

External Auditory Canal and Temporal Bone Carcinoma with Parotid Gland and Facial Nerve Involvement

External Auditory Canal and Temporal Bone Carcinoma with Parotid Gland and Facial Nerve Involvement

Temporal Bone Squamous Cell Carcinoma the Outcome of Radical Surgery as an Initial Treatment

Aims: The aim of this study is to analyse the clinical data and management of patients with temporal bone carcinoma and to discuss the management outcomes. Study Design: Retrospective study Place and Duration of Study: Universiti Kebangsaan Malaysia Medical Centre (academic tertiary centre) from January 2002 to December 2011. Methodology: Medical records of nine patients were retrieved for this study. There were seven male and two female patients. The mean age of presentation was 60 years old, with an age range between 49 to 75 years. The clinical presentations, investigations, staging, treatment modalities and outcomes are reviewed. Results: Four patients presented with primary tumour of the temporal bone, while the remaining five were referred from other centres with disease recurrence. Only one out of the five patients that were referred to us had underwent a lateral temporal bone resection Original Research Article British Journal of Medicine & Medical Research, 4(12): 2362-2368, 2014 2363 (LTBR) at presentation which was however an incomplete LTBR. Three out of the five patients (60%) have died with disease recurrence. One patient remained disease free while another patient was lost to follow up. Two out of the four patients who presented with primary tumour remained well while two others had positive margins due to advanced disease at presentation. Conclusion: Recurrence of disease is likely to occur if aggressive treatment is not offered at presentation or if the diagnosis is delayed. We therefore strongly suggest for early referral to a tertiary centre as aggressive primary surgical treatment with adjuvant radiotherapy shows a better prognosis.

Guidelines for Treating Temporal Bone Carcinoma Based on Long-Term Outcomes

To describe our experience in the management of patients with squamous cell carcinoma of the temporal bone (TBSCC) and to identify factors predictive of outcome. Retrospective study. Quaternary referral otology and skull base center. A total of 45 consecutive patients with histologically confirmed TBSCC were treated surgically at our institution between 1993 and 2011. Patients were divided into 5 stage I (11.1%), 6 stage II (13.3%), 15 stage III (31.1%), and 19 stage IV tumors (42.2%) according to the University of Pittsburgh modified TNM staging system. Twenty-one patients underwent lateral temporal bone resection, and 24 underwent subtotal temporal bone resection. Postoperative radiotherapy was performed in 27 cases. The 5-year disease-specific survival (DSS) and recurrence-free survival (RFS) for patients with early-stage disease (Stages I and II) was 100%. The 5-year DSS and RFS rates for patients with advanced disease (Stages III and IV) were 65.1% and 59.6%, respectively. On univariate analysis, factors that had a significant effect on both DSS and RFS were advanced Pittsburgh stage, presence of facial nerve palsy, positive tumor margins, and invasion of the fallopian canal, medial wall, middle ear, mastoid, temporomandibular joint, jugular bulb, and dura. Multivariable analysis identified only dural involvement as an independent predictor for both DSS and RFS. In this study, the Pittsburg staging system allowed an estimation of the prognosis. In fact, the prognosis of TBSCC was strictly correlated to tumor stage. The poor prognosis of advanced stage tumors underlines the importance of early diagnosis. Surgery with or without adjuvant radiotherapy remains the standard of care in the treatment of TBSCC.

Expression of the tumour-suppressor maspin in temporal bone carcinoma

Although it accounts for fewer than 0.2% of all head and neck tumours, temporal bone squamous cell carcinoma (SCC) is an aggressive malignancy with a poor prognosis in advanced cases. Novel therapeutic strategies should be developed focusing on specific targeted therapies. Maspin is a serpin showing tumour-suppressing activity which has therapeutic potential. The present study is the first to investigate maspin expression in temporal bone SCCs, using a series of 29 cases. Cytoplasmic maspin expression was significantly higher in the group of patients whose SCC did not recur than in the group experiencing recurrences (P = 0.029), and in G1-G2 SCCs than in G3 cases (P = 0.001). cT correlated with recurrence rate (P = 0.05), disease-free survival (DFS) (P = 0.008) and disease-specific survival (DSS) (P = 0.0043), and pT and pathological regional lymph node status correlated with recurrence rate (P = 0.008 and P = 0.03, respectively), DFS (P = 0.017 and P = 0.0049, respectively) and DSS (P = 0.008 and P = 0.0009, respectively). Although further studies using larger series are required, our preliminary findings suggest that cytoplasmic maspin expression has promise as a prognostic indicator of disease recurrence in temporal bone SCC, and that reactivating maspin functions in association with apoptosis-inducing or anti-angiogenic chemotherapeutic agents might be an important goal in the treatment of temporal bone SCC.