Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6

Introduction. Temporal bone Schneiderian papillomas (TBSPs) rarely present as a primary tumors arising from the middle ear and mastoid process. The clinical findings and imaging of TBSPs are not specific. Therefore, diagnosis can only reliably be definitively established by histopathology. Objective...

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Main Authors: O. Marzouk, F. Brasch, I. Todt, P. K. C. Goon, H. Sudhoff
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2021/6684254
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author O. Marzouk
F. Brasch
I. Todt
P. K. C. Goon
H. Sudhoff
author_facet O. Marzouk
F. Brasch
I. Todt
P. K. C. Goon
H. Sudhoff
author_sort O. Marzouk
collection DOAJ
description Introduction. Temporal bone Schneiderian papillomas (TBSPs) rarely present as a primary tumors arising from the middle ear and mastoid process. The clinical findings and imaging of TBSPs are not specific. Therefore, diagnosis can only reliably be definitively established by histopathology. Objective. To report a novel case of a malignant transformation of TBSP associated with HPV-6 and to present its management. Case Report. A 68-year-old woman presented with conductive hearing loss and recurrent right-sided otorrhoea. Initially, we performed a lateral temporal bone resection and obliteration with abdomen fat. Early histology described TBSP associated with HPV-6. Follow-up detected malignant transformation of the Schneiderian papillomatous variant. Postoperative radiotherapy combined with extended temporal bone resection resulted in a disease-free 17-month period of follow-up. Discussion. TBSPs are not very specific, and the diagnosis can only reliably be established by histopathology. There is a risk of malignant transformation, and due to the absence of reliable prognostic markers, strict postoperative follow-up is mandatory and should consist of regular otoscopy, nasal endoscopy, and imaging. This case also supports the importance of extended temporal bone resections as salvage surgery, combining radical surgery with radiotherapy for improved survival rates.
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spelling doaj-art-b01da6f45717497ba2f0ad715f5da85d2025-02-03T00:58:50ZengWileyCase Reports in Otolaryngology2090-67652090-67732021-01-01202110.1155/2021/66842546684254Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6O. Marzouk0F. Brasch1I. Todt2P. K. C. Goon3H. Sudhoff4Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum, Bielefeld, GermanyDepartment of Pathology, Academic Teaching Hospital Bielefeld, Bielefeld, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum, Bielefeld, GermanyDepartment of Dermatology, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UKDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum, Bielefeld, GermanyIntroduction. Temporal bone Schneiderian papillomas (TBSPs) rarely present as a primary tumors arising from the middle ear and mastoid process. The clinical findings and imaging of TBSPs are not specific. Therefore, diagnosis can only reliably be definitively established by histopathology. Objective. To report a novel case of a malignant transformation of TBSP associated with HPV-6 and to present its management. Case Report. A 68-year-old woman presented with conductive hearing loss and recurrent right-sided otorrhoea. Initially, we performed a lateral temporal bone resection and obliteration with abdomen fat. Early histology described TBSP associated with HPV-6. Follow-up detected malignant transformation of the Schneiderian papillomatous variant. Postoperative radiotherapy combined with extended temporal bone resection resulted in a disease-free 17-month period of follow-up. Discussion. TBSPs are not very specific, and the diagnosis can only reliably be established by histopathology. There is a risk of malignant transformation, and due to the absence of reliable prognostic markers, strict postoperative follow-up is mandatory and should consist of regular otoscopy, nasal endoscopy, and imaging. This case also supports the importance of extended temporal bone resections as salvage surgery, combining radical surgery with radiotherapy for improved survival rates.http://dx.doi.org/10.1155/2021/6684254
spellingShingle O. Marzouk
F. Brasch
I. Todt
P. K. C. Goon
H. Sudhoff
Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
Case Reports in Otolaryngology
title Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
title_full Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
title_fullStr Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
title_full_unstemmed Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
title_short Malignant Transformation of Temporal Bone Schneiderian Papilloma Associated with HPV-6
title_sort malignant transformation of temporal bone schneiderian papilloma associated with hpv 6
url http://dx.doi.org/10.1155/2021/6684254
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AT pkcgoon malignanttransformationoftemporalboneschneiderianpapillomaassociatedwithhpv6
AT hsudhoff malignanttransformationoftemporalboneschneiderianpapillomaassociatedwithhpv6