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Summary The patient developed repeated itching and scabbing at the mouth of the left external auditory canal 5 years ago. In the last two years, the tumor is enlarged. After admission, the left external auditory canal can be seen as a reddish mass, brittle and easy to bleed. CT of temporal bone showed that the soft tissue shadow of left external auricle and external auditory canal was thickened. Postoperative pathological findings: (left external auditory canal) basal cell squamous cell carcinoma. According to the history, physical examination and laboratory examination, the diagnosis is considered as basal squamous cell carcinoma of the external auditory meatus., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

The aim of the study was to present a case of small cell carcinoma of external auditory canal and associated facial nerve paralysis. Extrapulmonary small cell carcinoma from the head and neck is rarely described and carries a poor prognosis. To our knowledge, this is the first case report describing small cell carcinoma of the EAC in our nationality. This study includes a case report and review of the literature., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To summarize the clinical characteristics and therapeutic experiences of the middle ear teratoma in infants. Methods: Three cases of middle ear teratoma, from 2012-2015 in Beijing Friendship Hospital were analyzed. Results: The three cases all developed slowly and presented unilateral otorrhea and hearing loss. Otoscopy showed the granulation tissue in the external ear canal. Audiological changes varied according to the degree of severity. Imaging features showed the pocket-like occupancy lesions in the Eustachian tube area. The temporal bone CT showed mass with soft tissue density usually involved in the mastoid and tympanic cavity. MRI showed mixed signal intense on both T1 and T2 weighted imaging. All the three cases received neoplasm resection of the middle ear. Only one case received tympanoplasty surgery at the same time. And all the pathology results displayed mature teratoma. The follow-up time was 17 to 54 months. MRI showed complete removal of the tumor. Conclusions: Teratoma are rare in the head and neck neoplasm. When the infants suffer from the unilateral otorrhea, hearing loss, and granulation tissue formed in the external ear canal, it should be vigilant for teratoma. The differential diagnosis is middle ear cholesteatoma, congenital first branchial cyst or fistula, and middle ear carcinoma. Temporal bone CT combined with MRI could improve the accuracy of diagnosis. It should be totally resection as soon as possible if there is no contraindication. Postoperative follow-up and imaging examination are necessary to eliminate tumor recurrence.

Objective: Endolymphatic sac tumors (ELSTs) are rare in the general population with much higher prevalence in von Hippel-Lindau(VHL) disease. The purpose of this study is to present two cases of endolymphatic sac tumor with VHL disease with analysis of VHL gene and to explore their association with VHL disease using molecular analysis., Methods: Clinical data of these two patients from different VHL families were studied. DNAs extracted from peripheral bloods were amplified by the polymerase chain reaction using oligonucleotide primers corresponding to the VHL gene, then compared the mutations with the Human Gene Mutation Database., Results: In case 1, 6 family members were enrolled in the study. Among them, three had been identified to have a germline missense point mutation at codon 194 of the VHL gene exon 1 (p.S65W). The little sister of the patient (case 1) underwent vitrectomy for retinal hemangioblastoma 5 years ago in another hospital. The mother of the patient (case 1) was further diagnosed to have a cerebellar hemangioblastoma and renal carcinoma in the following physical examination. Case 2 with her parents were also tested. Codon 499 of the VHL gene exon 3 (p.R167W) were detected in case 2 and her mother, but the mother refused further examination., Conclusions: The genetic diagnosis plays an important role in early detection of symptomatic patients and suspected patients. Clinical screening for members of the VHL families, and close follow-up of carriers allow an early detection of tumors and the metastasis, which is the most common cause of death of these patients.

Ear infection is the most common cause of brain abscess. A suppurative process in the ear has access to the central nervous system by direct extension or through preformed pathways, either developmental, traumatic or pathologic, or by retrograde spread along the thromobophlebitic vein. Squamous cell carcinoma of middle ear or mastoid cavity is a rare disease and often associated with chronic otitis or chronic draining ear. Ear malignancy easily produces the destruction of temporal bone which may serve as a route for coexistent infection spreading into the brain. This paper reports a case of brain abscess occurring in a patient with temporal bone cancer. To the best of our knowledge, no more than three similar cases have been reported in the literature. The authors suggest that if an otogenic brain abscess is concomitant with infection and granulomatous mass in the ear, biopsy should be performed to rule out malignancy.