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Li JY, Sun LX, Hu N, Song GS, Dou WQ, Gong RZ, Li CT. Eustachian tube teratoma: A case report. World J Clin Cases 2022; 10:316-322. [PMID: 35071534 PMCID: PMC8727263 DOI: 10.12998/wjcc.v10.i1.316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/23/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease. Teratomas involving the temporal bone are particularly scarce.
CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy, for which he had been operated on twice, was referred to our hospital for chronic otitis, cholesteatoma and a middle ear mass. Computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a eustachian tube teratoma, in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue. The mass was removed completely under general anesthesia by mastoidectomy. As of last follow-up (2 years post-surgery), the disease had not relapsed.
CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma. Complete surgical resection provided excellent prognosis.
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Affiliation(s)
- Jin-Ye Li
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Li-Xin Sun
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Na Hu
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Ge-Sheng Song
- Department of Radiology, Shandong Province Qianfoshan Hospital, Jinan 250021, Shandong Province, China
| | - Wei-Qiang Dou
- GE Healthcare, MR Research China, Beijing 100000, China
| | - Ruo-Zhen Gong
- Gong Ruozhen Innovation Studio, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Chuan-Ting Li
- Department of Radiology, Shandong Province Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
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Presence of Two Separate Hairy Polyps with Meningothelial Elements in a 15-Month-Old Child. Case Rep Otolaryngol 2021; 2021:1844244. [PMID: 34594584 PMCID: PMC8478528 DOI: 10.1155/2021/1844244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Hairy polyps are benign embryological tumors of the head and neck region that are derived from two germinal layers, the ectoderm and mesoderm. At an incidence of 1 : 40000, hairy polyps are considered rare growths. Presenting symptoms of hairy polyps can vary greatly depending on the size and location of the tumor. To the best of our knowledge, our reported case is the first in the literature to highlight an extremely rare occurrence of two separate hairy polyps being simultaneously present in one patient, in the clivus and the nasion, with the presence of meningothelial cells within both tumors, histopathologically. With surgical resection as the management of choice, the approach of surgery differs greatly depending on many factors. Since the patient in our reported case had a cleft palate, we used a combined transnasal and transoral approach to fully release the clival mass and a direct skin incision for the nasion mass. Recurrence after complete surgical resection is rare, and if happens, it should rise suspicion of histopathologically misdiagnosed tumor. We amplified the importance of advanced radiological investigations along with proper multidisciplinary teamwork to exclude CNS connections and other histologically malignant tumors and to early pick up a possible simultaneous lesion.
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Mohd Zulkefli NA, Abdullah A, Hashim ND, Nasseri Z, Kew TY. Mastoid Abscess in a Child With Eustachian Tube Dermoid Cyst. Cureus 2021; 13:e15326. [PMID: 34221773 PMCID: PMC8239477 DOI: 10.7759/cureus.15326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A dermoid cyst (DC) is a benign tumor caused by inclusion errors during embryogenesis. DC of the head and neck is a well-recognized entity both clinically and histologically; however, it rarely occurs in the Eustachian tube (ET). Due to its anatomical position, significant morbidity related to middle ear dysfunction may result from ET obstruction. In this report, we present a rare case of a girl child aged two years and nine months with persistent otorrhea, who was initially diagnosed with acute otitis media with mastoiditis, along with suspicion of congenital cholesteatoma. However, high-resolution CT (HRCT) temporal and MRI of the neck revealed a DC of the ET causing left chronic otitis media (COM) with mastoid abscess. The patient underwent mastoid exploration surgery and myringotomy with grommet insertion. Although complete excision is the standard treatment modality for DC, the treatment of poorly ventilated mastoid and middle ear takes precedence over it. MRI surveillance scan is recommended in such cases.
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Affiliation(s)
| | - Asma Abdullah
- Otorhinolarygology/Otology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Noor Dina Hashim
- Otorhinolarygology/Otology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Zara Nasseri
- Otorhinolarygology/Otology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Thean Yean Kew
- Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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Chen S, Huang Y, Li Y. A case series of dermoids in the middle ear. Int J Pediatr Otorhinolaryngol 2021; 140:110472. [PMID: 33221033 DOI: 10.1016/j.ijporl.2020.110472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/25/2020] [Accepted: 10/25/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Dermoid is a rare disease located in the head and neck and only sporadic cases were previously reported. Surgery with different operational paths is the best solution to the disease. We aimed to analyze the clinical characteristics and outcomes of surgical approach for treating dermoid originated from the middle ear and Eustachian tube. METHODS In this retrospective case series, four cases of dermoids of the middle ear and Eustachian tube, treated by endoscopic-assisted surgical approach were reviewed and analyzed. RESULTS Patients' ages ranged from 7 months to 16 years. All cases involved the middle ear, eustachian tube, and the parapharyngeal space. Postoperative follow-up ranged from 6 months to 11 years. No facial nerve paralysis was observed during or after surgeries. Treatment was efficient in the four cases, with no residual symptoms during post-operative follow-up. CONCLUSIONS Dermoid of the middle ear involving the eustachian tube usually appears in children of early age. Surgical resection with assistance of endoscope has satisfying outcome for these cases.
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Affiliation(s)
- Shubin Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
| | - Yanran Huang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China
| | - Yongxin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China
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5
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Affiliation(s)
- Baiya Li
- Department of Head-Neck-Otolaryngology
| | - Yuan Deng
- Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi Province, P.R. China
| | | | - Yuan Shao
- Department of Head-Neck-Otolaryngology
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6
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Melzer JM, Morgan A, Darrow D. Congenital choristoma (hairy polyp) of the eustachian tube: Surgical management of a rare clinical entity. EAR, NOSE & THROAT JOURNAL 2017; 95:E43-5. [PMID: 26829696 DOI: 10.1177/014556131609500106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jonathan M Melzer
- Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center, Portsmouth, VA, USA
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7
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CT and MR imaging findings of teratoma of the Eustachian tube. Diagn Interv Imaging 2017; 98:269-271. [PMID: 28038916 DOI: 10.1016/j.diii.2016.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/29/2016] [Accepted: 10/14/2016] [Indexed: 01/11/2023]
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Cantarella G, Gaffuri M, Pugni L, Pignataro L, Mosca F. Severe respiratory distress at birth caused by a hairy polyp of the Eustachian tube: Transoral endoscopy-guided treatment. Congenit Anom (Kyoto) 2015; 55:158-60. [PMID: 25483752 DOI: 10.1111/cga.12100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 11/30/2014] [Indexed: 11/30/2022]
Abstract
Hairy polyps are rare developmental lesions, which present as masses mainly consisting of fatty tissue covered by skin, seldom localized in the nasopharynx, causing respiratory obstruction. We describe the case of a female newborn affected by a hairy polyp arising from the left Eustachian tube, who presented severe respiratory distress soon after birth. The polyp was successfully removed transorally under videoendoscopic guidance. This case highlights the importance of including hairy polyp in the differential diagnosis of respiratory distress at birth because this type of tumor can be lethal and requires prompt treatment. A transoral endoscopy-guided approach can allow successful and minimally invasive excision even in a newborn.
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Affiliation(s)
- Giovanna Cantarella
- Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Michele Gaffuri
- Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lorenza Pugni
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lorenzo Pignataro
- Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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9
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Lepera D, Volpi L, De Bernardi F, Shawkat SA, Cimetti L, Bignami M, Castelnuovo P. Endoscopic transnasal resection of Eustachian-tube dermoid in a new-born infant. Auris Nasus Larynx 2015; 42:235-40. [PMID: 25582821 DOI: 10.1016/j.anl.2014.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/14/2014] [Accepted: 10/22/2014] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Dermoids of the Eustachian tube are rare benign developmental tumours that typically occur in female children. General consensus of classification and nomenclature has still not been reached. The treatment of choice consists of a radical surgical excision. Several approaches have been described and few cases are reported in literature. A gross total resection is now safely achievable through an endoscopic mini-invasive approach. MATERIALS AND METHODS We have reported a case of dermoid pedicled in the left Eustachian tube and resected with a pure endoscopic transnasal approach. A review of the literature was performed. CASE STUDY The aim of this paper is to present the first case of pure endoscopic transnasal resection in a 4-day-old infant as emergency treatment of Eustachian tube dermoid presenting an acute respiratory failure at birth. CONCLUSION The endoscopic transnasal resection is a safe and feasible technique in selected dermoids of the Eustachian tube, when the middle ear is not involved. This approach could be used also in new-born children, decreasing the morbidity of the classic surgical treatment and avoiding the risk of craniofacial alterations.
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Affiliation(s)
- Davide Lepera
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Luca Volpi
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
| | - Francesca De Bernardi
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - S Alaa Shawkat
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Laura Cimetti
- Department of Surgical and Morphological Sciences, Anatomic Pathology Unit, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
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Naso-oropharyngeal choristoma (hairy polyps): an overview and current update on presentation, management, origin and related controversies. Eur Arch Otorhinolaryngol 2014; 272:1047-59. [PMID: 24771213 DOI: 10.1007/s00405-014-3050-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 04/03/2014] [Indexed: 01/30/2023]
Abstract
This review presents a comprehensive and updated overview of bigerminal choristomas (hairy polyps) of naso-oropharynx/oral cavity, and discusses the controversies related to nosology and origin from a clinico-embryologic perspective. English-language texts of the last 25 years (January 1989-January 2014) were collected from the PubMed/MEDLINE database using the given keywords. Of the 330 records, 64 full-text articles (mostly case reports/series) were selected, incorporating clinical data from 78 patients, after screening through duplicates and the given exclusion criteria. With the available evidence, hairy polyps appear more common than generally believed, and are increasingly being recognized as an important, often-missed cause of respiratory distress and feeding difficulty in neonates and infants. Such a child without any apparent cause should be examined with flexible nasopharyngoscope to specifically look for hairy polyps which might be life-threatening, especially when small. The female preponderance as believed today has been found to be an overestimation in this review. These lesions are characteristically composed of mature ectodermal and mesodermal tissue derivatives presenting as heterotopic masses, hence termed choristoma. However, little is known about their origin, and whether they are developmental malformations or primitive teratomas is debatable. Involvement of Eustachian tube and tonsils as predominant subsites and the speculated molecular embryogenesis link hairy polyps to the development of the first and second pharyngeal arches. They are exceptionally rare in adults, but form a distinct entity in this age-group and could be explained as delayed pluripotent cell morphogenesis or focal neoplastic malformations, keeping with the present-day understandings of the expanded "teratoma family".
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Nalavenkata S, Meller C, Forer M, Patel NP. Dermoid cysts of the eustachian tube: clarification [corrected] of histopathology. Int J Pediatr Otorhinolaryngol 2013; 77:1624. [PMID: 23886496 DOI: 10.1016/j.ijporl.2013.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 06/22/2013] [Indexed: 10/26/2022]
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12
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Muzzi E, Trabalzini F, Orzan E. Letter to the Editor regarding 'Germ-cell tumors of the Eustachian tube: a necessary update'. Int J Pediatr Otorhinolaryngol 2013; 77:1624-5. [PMID: 23876360 DOI: 10.1016/j.ijporl.2013.06.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 06/22/2013] [Indexed: 11/18/2022]
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