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Case Reports
. 2012:2012:690148.
doi: 10.1155/2012/690148. Epub 2012 Apr 3.

Giant cell tumor of the temporal bone with direct invasion into the middle ear and skull base: a case report

Takashi Iizuka  1 , Masayuki Furukawa, Hisato Ishii, Misato Kasai, Chieri Hayashi, Hajime Arai, Katsuhisa Ikeda
Affiliations
Case Reports

Giant cell tumor of the temporal bone with direct invasion into the middle ear and skull base: a case report

Takashi Iizuka et al. Case Rep Otolaryngol. 2012.

Abstract

Giant cell tumor (GCT) is classified as a benign bone tumor, and it is frequently identified at the epiphysis of long bones and relatively rare in the temporal bone. For orthopedists expert at recognizing bone and soft tissue tumors, the diagnosis of GCT is relatively easy; however, since head and neck surgeons experience few cases of GCT, it may be difficult to diagnose when it occurs in the temporal bone. A 32-year-old man complained of left hearing loss, aural fullness, and tinnitus. Examination of the ear revealed a bulging tumor. Audiologic examination demonstrated conductive hearing loss of the left ear. Computer tomograph of the temporal bone showed a soft-tissue-density specification indicating bone destruction at the left temporal bone. The tumor invaded the skull base. Imaging examinations using magnetic resonance imaging revealed a nonhomogenous isosignal intensity area on T1 at the left temporal bone. After intravenous gadolinium, the mass showed unequal enhancement. This patient subsequently underwent surgery to remove the lesion using transmastoid and middle fossa approach. Pathological examinations from specimens of the tumor revealed characteristic of GCT. No clinical or radiological evidence of tumor recurrence was detected for 4 years.

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Figures

Figure 1
Figure 1
Otoscopy of the left ear. The subcutaneous, bulging tumor was seen from the flaccid part to the umbo of the left tympanic membrane.
Figure 2
Figure 2
Temporal bone computed tomographic scan shows soft tissue shadow from the bone destruction with massive extension to the epitympanum and ossicular chain (a). In the coronal section, the tumor invades the skull base, and the outline of the tumor shows osteosclerosis with decalcification (b). Magnetic resonance imaging of the head revealed a mass 3 cm in diameter at the left temporal bone that was unequally enhanced after intravenous gadolinium (c). At the coronal section, the border with the tumor and the left mandible head was indistinct. In addition, the dura mater of the middle cranial fossa showed enhancement (d).
Figure 3
Figure 3
Intraoperative photographs. Transmastoid and middle fossa approach. The tumor was peeled from the middle fossa dura. Arrowhead: giant cell tumor, arrow: dura of the middle cranial fossa.
Figure 4
Figure 4
HE staining from the specimens of the tumor. Round and spindle-shaped mononuclear cells and numerous multinucleated giant cells. Arrow: giant cell.
See this image and copyright information in PMC

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