Middle Ear Adenomatous Neuroendocrine Tumour: A Rare Entity

Middle ear adenomatous neuroendocrine tumors (MEANT) are rare, mainly benign neoplasms and account for less than 2% of the middle and inner ear neoplasms. There are no specific radiological or clinical findings; therefore, the diagnosis is often difficult. Biopsy prior to surgery is often proposed. The definite treatment is the complete surgical resection. We present an uncommon clinical report of a MEANT, which was treated successfully with surgicalexcision. CaseDescription: A 43-year-old man was referred to our ear, nose, and throat (ENT) outpatient clinic with a 6-month history of progressive left hearing loss and ear fullness. His personal and family medical history was unremarkable. Otomicroscopy revealed an ear mass filling the left external auditory canal. Due to the volume of the mass, it was not possible to clarify its starting point or to visualize the tympanic membrane. Both the Weber and Rinne tests indicated conductive hearing loss on the affected side. Audiometry confirmed conductive mild hearing loss at low and middle frequencies and moderate hearing loss at high frequencies on the left side. The rest of the ENT clinical examination was normal. A contrast-enhanced computed tomography (CT) scan was performed revealing a soft tissue mass arising from the middle ear, extending into the external auditory canal. The mass localized into the middle ear with extent to the attic, pushing and dislocating the ossicles, without affecting the medial wall and promontory. A biopsy of the visible mass was taken under local anesthesia after the CT scan. The mass was quite haemorrhagic and adrenaline–xylocaine solution was required. Histopathology and immunochemistry showed a middle ear adenomatous neuroendocrine tumour (MEANT). Discussion: Middle ear adenomatous neuroendocrine tumours are extremely rare (less than 2% of middle and inner ear neoplasms), mainly with benign characteristics. They derive from the glandular components of middle ear and they differentiate into glandular, neuroendocrine,or both directions. Concerning epidemiology, there is not a specific decade of onset, while there is not male or female predominance. It is still under investigation whether MEANTs and carcinoid tumours are separate diseases or expression of the same entity

Author(s): Katerina Marini

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