Pathology of the Head and Neck

250 L. MichaelsTable 8.1. Schneiderian-type or inverted papillomas of the middle ear described in the literatureCasenumberLiteraturesourceHistological description givenPossible alternative diagnosis81 [110] “Inverted papilloma” and high-grade carcinoma Squamous cell carcinoma ofthe middle ear2 [52] “Transitional cell papilloma”Inverted papilloma in noseInverted papilloma derivedfrom a nasal tumour3 [93] Entirely papillary Papilloma of the middle ear4 [98] Malignant change in inverted papilloma Squamous cell carcinomaof the middle ear5 [124]Case 16 [124]Case 27 [124]Case 38 [124]Case 49 [124]Case 5“Epidermoid papilloma” with “inverted” and “cylindriccell papilloma”“Epidermoid papilloma” with exophytic and endophyticgrowth“Epidermoid papilloma” with features of “cylindric cellpapilloma”“Epidermoid papilloma” with features of “cylindric cellpapilloma”“Epidermoid papilloma” with features of “cylindric cellpapilloma”Papilloma of the middle earPapilloma of middle earPapilloma of the middle earPapilloma of the middle earPapilloma of the middle ear10 [51] Squamous epithelium with areas of carcinoma in situ Squamous carcinoma ofthe middle ear11 [17] Papillary with areas of squamous epithelium adjacent to Papilloma of the middle earrespiratory epithelium12 [90]None ?Case 113 [90]?Case 214 [11]Two casesInsufficient description ?and neck, including jugulotympanic, paragangliomasthere is, unlike the solitary jugulotympanic paraganglioma,a preponderance for the male sex and inheritanceis autosomal dominant, with increased penetrancewith age [5]. There is evidence from moleculargenetic studies that the gene underlying familial paragangliomasis located on chromosome 11q proximal tothe tyrosinase gene locus [59].The neoplasm is a reddish sprouting mass at its externalcanal surface. In the jugular variety the petroustemporal bone is largely replaced by red, firm materialand the middle ear space is occupied by soft neoplasm asfar as the tympanic membrane. The otic capsule is rarelyinvaded by paraganglioma. Investigation of a paragangliomain an autopsy temporal bone by the microslicingmethod showed the origin of the tumour to be inthe jugular bulb region and its spread through the petrousbone and middle ear to the tympanic membrane(Fig. 8.15). The histology of paraganglioma is describedin Chap. 9 (Fig. 8.16) [55].The incidence of clinically functioning paragangliomawith symptoms and signs of norepinephrine excess,particularly hypertension, is only 1–3% [97].Jugulotympanic paraganglioma is a neoplasm of slowgrowth. The jugular variety infiltrates the petrous bone,but distant metastasis is rare. Radiation therapy, and insome cases surgery, offers a high rate of cure for theseneoplasms and the number of patients who do badly aftersuch therapy is very small.8.3.2.5 Squamous Cell CarcinomaICD-O:8070/3Squamous cell carcinoma is uncommon in the middleear. It sometimes accompanies squamous cell carcinomaof the external canal or may arise solely from themiddle ear epithelium. The patient always has an auraldischarge and conductive hearing loss. Pain in the ear,bleeding and facial palsy are common.