Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2007; 13(47): 6436-6438
Published online Dec 21, 2007. doi: 10.3748/wjg.v13.i47.6436
Metastatic hepatocellular carcinoma of the external auditory canal
Ryuji Yasumatsu, Kenji Okura, Yumiko Sakiyama, Makoto Nakamuta, Taisei Matsumura, Satoru Uehara, Tomoya Yamamoto, Shizuo Komune
Ryuji Yasumatsu, Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University and Department of Otorhinolaryngology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 812-8582, Japan
Kenji Okura, Tomoya Yamamoto, Department of Otorhino-laryngology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 812-8582, Japan
Yumiko Sakiyama, Makoto Nakamuta, Department of Gastro-enterology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 812-8582, Japan
Taisei Matsumura, Satoru Uehara, Department of Radiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 812-8582, Japan
Shizuo Komune, Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Ryuji Yasumatsu, Department of Otorhi-nolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. yasuryuj@qent.med.kyushu-u.ac.jp
Telephone: +81-92-6425668 Fax: +81-92-6425685
Received: August 29, 2007
Revised: September 28, 2007
Accepted: November 22, 2007
Published online: December 21, 2007
Abstract

This report describes a rare case of metastatic hepatocellular carcinoma (HCC) presenting a huge mass in the left external auditory canal (EAC). The patient was a 55-year-old man with hepatitis B virus-related HCC. He presented to our department with a three-month history of increasing left otalgia, and hearing loss with recent fresh aural bleeding. Histopathologic examination indicated that the tumor was secondary to HCC. Although external irradiation was not effective, the tumor was treated with surgical debulking and high dose rate 192 Ir remote afterloading system (RALS) for postoperative intracavitary irradiation. A review of the literature revealed only five other cases of HCC metastasis to the temporal bone, all of which mainly metastasized in the internal acoustic meatus. The present case is the first report of HCC metastasis to the EAC.

Keywords: Hepatocellular carcinoma; Metastasis; External auditory canal