The misdiagnosis of external auditory canal carcinoma
The misdiagnosis of external auditory canal carcinoma
复制标题
DOI：
10.1007/s00405-012-2159-4
复制
发表时间：
2013-05-01
影响因子：
2.6
通讯作者：
Wang, ZhengMin
中科院分区：
文献类型：
--
作者：
Zhang, Ting;Dai, ChunFu;Wang, ZhengMin
外耳道癌常被误诊。本研究的目的是对误诊病例进行回顾，并分析相关因素。本研究为回顾性评估。在眼科和耳鼻喉科医院就诊的44例EAC癌病例中，有18例被误诊。回顾性分析所有病例的年龄、性别、临床症状、误诊类型、CT或MRI表现、肿瘤分期、手术方式、组织病理学检查、持续治疗（术后放疗）和治疗结果。误诊为中耳炎6例，外耳道炎5例，外耳道乳突瘤2例。其他误诊包括外耳道狭窄、耳神经痛、外耳道疖、外耳道良性肿瘤和耳前瘘管。我们的分析表明，如果怀疑EAC癌，在中耳炎或外耳炎对常规抗菌药物无反应的情况下，应进行活检以获得组织病理学诊断。头颈部MRI应用于探查软组织受累。有血性耳分泌物和耳痛的病人，特别是CT扫描显示颞骨侵蚀的病人，极有可能患有颞骨恶性癌。
External auditory canal (EAC) carcinomas are frequently misdiagnosed. The aim of this study was to conduct a review of misdiagnosed cases and analyze the factors involved. This study was a retrospective assessment. Eighteen of 44 EAC carcinoma cases seen at the Eye and ENT Hospital were misdiagnosed. All medical records were retrospectively analyzed for the age, sex, presenting symptoms, type of misdiagnosis, computed tomographic (CT) or magnetic resonance imaging (MRI) findings, stage of the cancer, surgical approach, histopathological examination, adjunctive therapy (postoperative radiotherapy) and outcomes of treatment. Six cases were misdiagnosed as otitis media, five cases were misdiagnosed as otitis externa, and two cases were misdiagnosed as external auditory canal cholesteatomas. Other misdiagnoses were stenosis of the EAC, ear neuralgia, furuncle of the EAC, benign neoplasm of the EAC and pre-auricular fistula. Our analyses suggest that a biopsy should be conducted to obtain a histopathological diagnosis if an EAC carcinoma is suspected, in case otitis media or otitis externa does not respond to routine anti-bacterials. Head and neck MRI should be used to explore the involvement of soft tissues. Patients with bloody ear discharge and otalgia, particularly with temporal bone erosion seen in a CT scan, are highly likely to have a malignant carcinoma of the temporal bone.