Middle ear and inner ear tumors - malignant

Squamous cell carcinoma

Topic Completed: 1 November 2013

Minor changes: 1 March 2021

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PubMed Search: Squamous cell carcinoma of middle inner ear

Nat Pernick, M.D.
Page views in 2020: 312
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Cite this page: Pernick N. Squamous cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earmiddlescc.html. Accessed December 8th, 2021.
Definition / general
  • Rare; usually age 50s and 60s
  • Usually > 20 year history of chronic otitis media or radiation therapy for intracranial tumor or middle ear inflammation
  • 25% have associated cholesteatomas
  • Symptoms: long standing chronic otitis media with sudden onset of pain, otorrhea, hemorrhage
  • 5 year survival: 39%; 10 year survival: 21%; usually no metastatic disease
Case reports
  • Radical surgery with radiation therapy, chemotherapy for advanced disease
Gross description
  • Tumor fills middle ear spaces, may invade walls of mastoid air cells, bone adjacent to carotid canal, internal auditory meatus, Eustachian tube and external auditory canal
Microscopic (histologic) description
  • Resembles squamous cell carcinomas at other sites, well to poorly differentiated
  • Infiltrative malignant cells with keratinization, intercellular bridges
Differential diagnosis
  • Cholesteatoma: no atypia
  • Direct invasion from nasopharynx, skin, external ear, parotid gland
  • Metastases: need good history to rule out
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