Carcinoid of the middle ear. A case report

The case of a 47-year-old patient is described with a carcinoid of the middle ear. Initial symptoms were hearing impairment, feeling of pressure and dizziness. Mastoidectomy was carried out for mastoid shadowing with space encroachment in the auditory canal. The histological examination initially revealed an atypical cholesteatoma and the subsequent immunohistochemical investigation revealed a carcinoid. A radical excavation with complete excision of the tumor and tympanoplasty was carried out. A carcinoid of the middle ear is definitely a rare finding and the primary treatment is complete surgical removal. If metastases are suspected octreotide scintigraphy has proved to be the best option in analogy to intestinal carcinoids. Radiation therapy has not proved successful but the use of the somatostatin analog octreotide, interferon-alpha or palliative chemotherapy (e.g. streptozotosine, 5-fluorouracil) for metastases are further therapy options.