Clinical Review & Education Clinical Problem Solving | PATHOLOGY Nathan C. Tu, AB; Stewart I. Adam, MD; Elias M. Michaelides, MD A B C D Figure. Axial computed tomographic images of the head showing (A) a soft-tissue mass within the right protympanum (arrowheads) and (B) air cell opacification and mastoid mucoperiosteal thickening and a dehiscent carotid artery. Histopathologic examination of the ear mass (hematoxylin-eosin; C, original magnification, ×4; D, original magnification, ×20). A man in his 70s with a history of a right middle ear lesion resected tumor encompassing portions of the incus, the tympanic mem- twice in the previous year at an outside institution was referred for brane, and the posterior middle ear was entirely excised. The sta- a recurrent right ear mass. He initially presented with progressive pes had been removed during a previous operation. bilateralhearingloss,moreprofoundintherightear,anddeniedotal- Histopathologicexaminationrevealedeosinophiliccuboidaland gia, otorrhea, tinnitus, vertigo, or feeling of fullness. He recalled a columnar cells forming tubules, along with solid, cribriform pat- distant history of military noise exposure but no other clinically sig- terns lining papillary fronds (Figure, C and D). Most cells had dark nificant otologic history. The physical examination revealed an ery- nuclei, with some showing stippled nuclear chromatin. Pleomor-
JAMA Otolaryngology - Head & Neck Surgery – American Medical Association
Published: Apr 1, 2014
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