Late metastasis of breast adenocarcinoma into internal auditory canal and cerebellopontine angle: case report.
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A case of metastasis of breast adenocarcinoma into the internal auditory canal (IAC) and cerebellopontine angle (CPA) is presented, which appeared 16 years after primary tumor had been treated by surgery and radiation therapy. The 66-year old patient was considered cured from the primary disease, when she started with a rapidly developing hearing loss and intermittent facial palsy. Magnetic resonance image (MRI) displayed an intra- and extracanalicular tumor mass, which radiologically resembled a vestibular schwannoma. Surgery was performed and histopathological studies showed an adenocarcinoma compatible with breast origin. Metastasis is a rare occurrence within the IAC and CPA. Clinical history of severe facial palsy will rise suspicion of malignant tumor in spite of the radiological findings. (+info)
SUMMARY: Three cases of intracanalicular meningioma mimicking vestibular schwannoma are presented. In each case, a contrast-enhancing mass filling the internal auditory canal was identified on MR images and was originally diagnosed as a vestibular schwannoma. Although it is difficult to differentiate definitively between these lesions preoperatively, imaging findings inconsistent with a diagnosis of vestibular schwannoma can be identified. Preoperative identification of intracanalicular meningiomas permits alterations in surgical planning that allow for the more complete resection of these rare tumors. (+info)
Primary ear and temporal bone meningiomas: a clinicopathologic study of 36 cases with a review of the literature.
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"Primary" ear and temporal bone meningiomas are tumors that are frequently misdiagnosed and unrecognized, resulting in inappropriate clinical management. To date, a large clinicopathologic study of meningiomas in this anatomic site has not been reported. Thirty-six cases of ear and temporal bone meningiomas diagnosed between 1970 and 1996 were retrieved from our files. Histologic features were reviewed, immunohistochemical analysis was performed (n = 19), and patient follow-up was obtained (n = 35). The patients included 24 females and 12 males, aged 10-80 years (mean, 49.6 years), with female patients presenting at an older age (mean, 52.0 years) than male patients (mean, 44.8 years). Patients presented clinically with hearing changes (n = 20), otitis (n = 7), pain (n = 5), and/or dizziness/vertigo (n = 3). Symptoms were present for an average of 24.6 months. The tumors affected the middle ear (n = 25), external auditory canal (n = 4), or a combination of temporal bone and middle ear (n = 7). The tumors ranged in size from 0.5 to 4.5 cm in greatest dimension (mean, 1.2 cm). Radiographic studies demonstrated a central nervous system connection in 2 patients. Histologically, the tumors demonstrated features similar to those of intracranial meningiomas, including meningothelial (n = 33), psammomatous (n = 2), and atypical (n = 1). An associated cholesteatoma was identified in 9 cases. Immunohistochemical studies confirmed the diagnosis of meningioma with positive reactions for epithelial membrane antigen (79%) and vimentin (100%). The differential diagnosis includes paraganglioma, schwannoma, carcinoma, melanoma, and middle ear adenoma. Surgical excision was used in all patients. Ten patients developed a recurrence from 5 months to 2 years later. Five patients died with recurrent disease (mean, 3.5 years), and the remaining 30 patients were alive (n = 25, mean: 19.0 years) or had died (n = 5, mean: 9.5 years) of unrelated causes without evidence of disease. We conclude that extracranial ear and temporal bone meningiomas are rare tumors histologically similar to their intracranial counterparts. They behave as slow-growing neoplasms with a good overall prognosis (raw 5-y survival, 83%). Extent of surgical excision is probably the most important factor in determining outlook because recurrences develop in 28% of cases. (+info)
Intralabyrinthine meningioma.
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An 18-year-old female patient with unilateral hearing loss underwent evaluation with CT and MR imaging. A partially ossified, enhancing lesion in the bony labyrinth, with replacement of adjacent structures, was identified. Surgical biopsy revealed a meningioma arising primarily within the bony labyrinth. To our knowledge, this entity has not been previously described. (+info)
Meningioma of the internal auditory canal: case report.
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Meningiomas limited to the internal auditory canal (IAC) are rare. Acoustic neuroma is usually the diagnosis made when a tumor is found in this location because of its higher frequency. We report on a 58 year-old woman with a meningioma arising from the IAC and the difficulty to establish the pre-surgical diagnosis, based on clinical and radiological features. The perioperative suspicion and confirmation are very important to deal with the dura and bone infiltration in order to reduce tumor recurrence. (+info)
T-cell lymphoma of the tympanic bulla in a feline leukemia virus-negative cat.
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This report constitutes the first description of a T-cell lymphoma of the tympanic bulla in a cat. This feline leukemia virus (FeLV)-negative cat originally presented with signs referable to middle ear disease; it deteriorated rapidly after definitive diagnosis. Lymphoma of the middle ear is extremely rare in all species. (+info)
Intravenous chemotherapy with cisplatin for regional lymph node metastases of auricular VX2 carcinoma.
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INTRODUCTION: The VX2 carcinoma is well established as a useful model for studies on treatment of primary tumors of various locations including the rabbit's auricle; however, limited experience exists on the treatment modalities of lymph node (LN) metastases. In this investigation we studied the frequency and extent of lymphogenic metastatic spread of auricular VX2-carcinomas and their response to systemic chemotherapy. MATERIALS AND METHODS: Induction of a right-sided auricular VX2-carcinoma in 17 healthy New Zealand white rabbits was followed by ablation of the right auricle and intravenous application of 1 mg/kg KG CDDP (cisdiamminedichloroplatinum (II)) dissolved in 2 ml NaCl via the left-sided auricular vein in 10 rabbits (group 1), while 7 rabbits (group 2) remained untreated. After a 24-day follow-up period, animals of both groups were sacrificed and the regional draining LN as well as the lungs were isolated and examined histopathologically. RESULTS: Group 1. Following intravenous cisplatin therapy (ICT), 6/10 animals showed no vital tumor cells within LN metastases of the first draining LN station, while 4/10 animals had necrotic LN metastases limited to the parotideal LN. Group 2. All 7 animals showed necrotic LN metastases of the first and second draining LN station as well as pulmonary metastases. CONCLUSION: The auricular VX2-carcinoma, characterized by frequent lymphogenic metastatic spread and response of LN metastases to ICT, offers an excellent animal model for further studies on the optimised treatment of lymphogenic metastatic spread in HNSCC. (+info)
Hemodynamic evaluation during balloon test occlusion of the sigmoid sinus: clinical and technical considerations.
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Test occlusion of a patent dural sinus requires careful hemodynamic evaluation. We performed balloon test occlusion of the sigmoid sinus in a patient with an advanced-stage temporal bone malignancy that affected the dominant sigmoid sinus. Before and during the test occlusion, intrasinus pressure was monitored upstream from the balloon via the inner lumen of a double-lumen angioplasty balloon microcatheter. On the basis of the hemodynamic findings, permanent balloon occlusion was carried out without complications. (+info)