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Glandular Tumors of the External Auditory Canal and Middle Ear

Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition

What’s inside

3 sections · 91 slides

  1. 01

    Overview

    • Scope of this presentation

    1 slide

  2. 02

    Glandular Tumours of the External Auditory Canal

    • Origin and frequency of glandular EAC tumours
    • Histological categories of ceruminous gland tumours
    • Presenting symptoms
    • Symptoms suggesting invasive disease
    • Gross appearance and tumour size
    • Age and sex distribution
    • Delay in diagnosis
    • The term ceruminoma
    • Wetli classification of ceruminous gland tumours
    • WHO classification of ceruminous gland neoplasms
    • Evidence for a ceruminous gland origin
    • Proposed origin of EAC pleomorphic adenoma
    • Computed tomography of glandular EAC tumours
    • MRI of a glandular external auditory canal tumour
    • Biopsy technique for canal lesions
    • Ceruminous adenoma: histology
    • Immunohistochemistry of ceruminous adenoma
    • Pleomorphic adenoma of the EAC: histology
    • Syringocystadenoma papilliferum of the EAC
    • Features favouring malignancy
    • Ceruminous adenocarcinoma: histology
    • Ceruminous adenocarcinoma microarchitecture and immunophenotype
    • Ceruminous adenoid cystic carcinoma: histology
    • Cytology and ceruminous origin in adenoid cystic carcinoma
    • Ceruminous mucoepidermoid carcinoma: histology
    • Surgery for benign glandular EAC tumours
    • Staging borrowed from squamous cell carcinoma
    • Pittsburgh staging system for external auditory meatus carcinoma
    • Resection for malignancy limited to the canal
    • Reconstruction after lateral temporal bone resection
    • Extent of temporal bone resection: the controversy
    • Anterior extension, neck disease and unresectable tumours
    • Aggressive resection for adenoid cystic carcinoma
    • Indications for adjuvant radiotherapy
    • Radiosensitivity by subtype: unsettled
    • Prognosis of benign EAC glandular tumours
    • Survival in malignant glandular EAC tumours
    • Poor prognostic factors
    • Patterns of recurrence and metastasis

    39 slides

  3. 03

    Glandular Tumours of the Middle Ear

    • Historical descriptions of middle ear glandular tumours
    • Shared epithelial and neuroendocrine features
    • Biological behaviour of glandular middle ear tumours
    • Age, sex and presenting complaint
    • Symptom frequency in middle ear glandular neoplasms
    • Mechanism of facial weakness
    • Regional and systemic manifestations
    • Computed tomography of middle ear glandular tumours
    • Computed tomography of a middle ear adenoma
    • Magnetic resonance imaging features
    • Distinguishing paraganglioma from glandular middle ear tumours
    • Differential diagnosis of a middle ear mass
    • Evaluation for metastatic disease
    • Theories of origin for middle ear glandular tumours
    • Rarity of middle ear carcinoid
    • Adenoma versus carcinoid: one entity or two
    • Light microscopy of middle ear adenoma and carcinoid
    • Nuclear features and the paraganglioma contrast
    • Immunohistochemistry and secretory products
    • Staining pattern follows architecture
    • Immunostaining to exclude paraganglioma
    • Aggressive subtypes and endolymphatic sac tumours
    • T categories in the middle ear adenoma staging system
    • Staging system for middle ear adenomas
    • Staging system for middle ear adenomas (continued)
    • Pictorial reference for T status in middle ear adenoma
    • Prognostic significance of the staging system
    • Recurrence rates by stage
    • Surgical approach by extent of disease
    • Tumours extending to the ear canal and gross appearance
    • Management of the ossicular chain
    • Facial nerve and regional disease at operation
    • Adjuvant therapy for glandular middle ear tumours
    • Factors influencing recurrence
    • Tumour biology and recurrence
    • Reported metastatic disease from middle ear carcinoid
    • Surveillance after treatment
    • Key points
    • Key points continued
    • References
    • References (continued)
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    • References (continued)
    • References (continued)
    • References (continued)
    • Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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    49 slides