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Ear Pathology Online

Pathology of Squamous Cell Carcinoma of the Middle/Inner Ear

Dr Sampurna Roy MD 


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Squamous cell carcinoma of the middle ear is a rare tumour.

 It accounts for 1.5% of malignant tumours in the ear.

The patient may have a history of chronic otitis media. Clinically, the patient may complain of aural discharge, conductive hearing loss, pain in the ear,bleeding and facial palsy.

Microscopic features:  Histologically, the tumour is similar in its range of keratinization and epithelial differentiation to tumours of the same histologic type elsewhere in the upper respiratory tract.

Carcinoma in-situ may be present focally adjacent to the invasive carcinoma.

Middle ear corpuscles may be confused with keratinized pearls of squamous carcinoma specially during frozen section. 

Spread:  There is penetration by tumour of the bony wall on the medial wall of the middle ear to infiltrate the carotid canal.

The tumour penetrates the thin layer of bone between the posterior mastoid air cells and the dura with subsequent invasion along the dura and into the internal auditory meatus.

In some cases the cochlea may be infiltrated.

There may be extensive involvement of the inner ear by cancer destroying the lower part of the otic capsule.

In such cases it is assumed that squamous cell carcinoma overcame the biological resistance to neoplastic infiltration which probably exists in the otic capsule and the membranous labyrinth.


Further reading:

Squamous cell carcinoma of the temporal bone: a radiographic-pathologic correlation.

Squamous cell carcinoma of the temporal bone arising 43 years after fenestration procedure.

Primary squamous cell carcinoma of the middle ear invading the cochlea. A histopathological case report.

Squamous cell carcinoma of the middle ear.

Squamous cell carcinoma of the middle ear: report of three cases.

Squamous cell carcinoma of the middle ear. A 25-year retrospective study.


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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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