Moderately differentiated squamous cell carcinoma of the temporal bone: a case report of an external auditory canal mass in an elderly patient

Abstract

Squamous cell carcinoma (SCC) of the temporal bone is a rare malignancy, often misdiagnosed due to its mimicry of inflammatory ear conditions. The occurrence is rare, reported at 1 to 6 per million population per year.

A 91-year-old female with diabetes, presented with one-year history of persistent right-sided otorrhoea, mixed hearing loss, and otalgia unresponsive to medical therapy. Physical examination revealed a polypoidal mass obstructing the External Auditory Canal (EAC). Contrast-enhanced CT scan identified soft tissue mass without bony erosion. Punch biopsy confirmed moderately differentiated SCC. The patient underwent modified radical mastoidectomy, followed by radiotherapy. At seven-month follow-up, imaging showed no residual tumour mass.

Surgical resection with negative margins followed by concurrent chemo-radiotherapy (CCRT) is the treatment of choice, but for tumour involving the intracerebral structures, radiotherapy is the treatment modality. This case is exceptionally rare as no previous report has described a 91-year-old patient with localised disease without bone, nodal, or cranial nerve involvement.

Keywords: Squamous cell carcinoma, Temporal bone, Ear neoplasm, Skull base neoplasm.