Aural polyp with facial asymmetry in an unfortunate infant

Temporal bone rhabdomyosarcoma is an aggressive entity that simulates chronic otitis ear infection. It is the most common soft tissue sarcoma amongst pediatric patients. Herein, we would like to report a case of temporal bone rhabdomyosarcoma involving a 2-year-old boy who presented with a one-month history of otorrhea with facial asymmetry. Early treatment led to remission of this severe neoplasm.

Clinicopathological study on aural polyp

<p class="abstract"><strong>Background:</strong> The study of the aural polyp was undertaken to emphasize various causes of the aural polyp and to highlight the importance of histopathology in the management of these cases.</p><p class="abstract"><strong>Methods:</strong> 50 patients who attended the ENT outpatient department with aural polyp were taken for the study. Aural polypectomy was done after clinical, radiological evaluation and examination under the microscope. Tissue was sent for histopathological examination. </p><p class="abstract"><strong>Results:</strong> The most common lesion was found to be Inflammatory polyp (50%), followed by cholesteatoma (30%), chronic non-specific inflammation (10%). Others included abscess (6%). One case each of squamous cell carcinoma and glomus were also reported. </p><p class="abstract"><strong>Conclusions:</strong> Aural polypectomy, followed by histopathological examination, may uncover serious disease processes and will assist in planning further management in extensive diseases. Though inflammatory polyp is the most common cause, vascular and malignant tumors should also be considered while evaluating the case.</p>

Case Report: Case report: A rare case of middle-ear Rhabdomyosarcoma in a 4-year-old boy

We present a rare case of a four-year-old boy with a botyroid embryonal rhabdomyosarcoma of the right middle ear. Rhabdomyosarcoma is a soft tissue malignancy which is thought to originate from embryonic mesenchymal cells of striated skeletal muscle. It is a disease primarily of children and is exceptionally rare in parameningeal regions. The diagnosis is often delayed and easily misdiagnosed as aural polyp. Therefore, advanced disease is common at the time of diagnosis. A four-year-old boy presented with a four-month history of recurrent left ear blood and pus discharge, otalgia and fevers. He attended his GP three times and paediatric A&E 13 times where he received antibiotics for presumed otitis media and externa. He was eventually referred to the otolaryngology department and underwent an examination under anaesthesia of ear and excisional biopsy of a suspicious aural polyp. Staging chest CT and PET scan showed no loco-regional spread or distal metastasis. Magnetic resonance imaging demonstrated absence of invasion into adjacent organs. Histology confirmed embryonal rhabdomyosarcoma, botryoid subtype. Subsequent to the initial excision of the polyp, he was started on an ifosfamine, vincristine and actinomycin (IVA) chemotherapy regime in three weekly cycles for nine cycles with concomitant radiotherapy. Two weeks subsequent to his first chemotherapy dose he presented with a House-Brackmann II-III facial nerve palsy but no other middle ear complications. He was started on intravenous antibiotics and dexamethasone. The facial nerve palsy incompletely resolved with treatment.

Case Report: Case report: A rare case of middle-ear Rhabdomyosarcoma in a 4-year-old boy

We present a rare case of a four-year-old boy with a botyroid embryonal rhabdomyosarcoma of the right middle ear. Rhabdomyosarcoma is a soft tissue malignancy which is thought to originate from embryonic mesenchymal cells of striated skeletal muscle. It is a disease primarily of children and is exceptionally rare in parameningeal regions. The diagnosis is often delayed and easily misdiagnosed as aural polyp. Therefore, advanced disease is common at the time of diagnosis. A four-year-old boy presented with a four-month history of recurrent left ear blood and pus discharge, otalgia and fevers. He attended his GP three times and paediatric A&E 13 times where he received antibiotics for presumed otitis media and externa. He was eventually referred to the otolaryngology department and underwent an examination under anaesthesia of ear and excisional biopsy of a suspicious aural polyp. Staging chest CT and PET scan showed no loco-regional spread or distal metastasis. Magnetic resonance imaging demonstrated absence of invasion into adjacent organs. Histology confirmed embryonal rhabdomyosarcoma, botryoid subtype. Subsequent to the initial excision of the polyp, he was started on an ifosfamine, vincristine and actinomycin (IVA) chemotherapy regime in three weekly cycles for nine cycles with concomitant radiotherapy. Two weeks subsequent to his first chemotherapy dose he presented with a House-Brackmann II-III facial nerve palsy but no other middle ear complications. He was started on intravenous antibiotics and dexamethasone. The facial nerve palsy incompletely resolved with treatment.

Inverted Papilloma of the Middle Ear presenting as an Aural Polyp

Objective: To present a rare case of inverted papilloma of the middle ear in a 77-year old man presenting with an external auditory canal polyp of the right ear. Methods Study Design: Case Report Setting: Tertiary Private Hospital Patient: One (1) Results: A 77-year old man presenting with external auditory canal mass underwent tympanoplasty with canal wall down mastoidectomy. Histopathologic examination revealed inverted papilloma. Conclusion: With only 30 cases reported in the literature, inverted papilloma of the middle ear is a rare disease entity that may mimic other benign conditions such as cholesteatoma. It requires further investigation to devise a rational approach to diagnosis and management. Regular post-operative monitoring is essential due to high recurrence and malignant transformation rate, while post-operative radiotherapy remains controversial and requires further investigation. Keywords: Inverted papilloma, cholesteatoma, middle ear

Capillary Hemangioma of the Temporal Bone

Objective: To discuss a rare case of temporal bone capillary hemangioma, and its diagnosis and management. Methods: Design: Case Report Setting: Tertiary Government Hospital Patient: One Results: A 44-year old woman with a history of on-and-off right ear discharge, tinnitus and decreased hearing, and a pinkish, smooth-surfaced, non-friable, non-pulsating mass occluding the right external auditory canal, was initially treated for chronic suppurative otitis media with aural polyp. A punch biopsy due to persistence of disease despite medical treatment revealed capillary hemangioma. She underwent canal wall down mastoidectomy with obliteration to completely resect the tumor. Conclusion: Capillary hemangiomas of the temporal bone are benign lesions that may lead to complications such as bone erosion, hearing loss, recurrent infection and bleeding if left untreated. Surgery remains the ideal treatment, and recurrence is rare and the prognosis is good if resection is complete. Keywords: Hemangioma, capillary hemangioma, temporal bone, middle ear