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Post-aural ache: an unusual presentation of a metastatic temporal bone lesion from a primary adenocarcinoma of the lung

Published online by Cambridge University Press:  14 October 2013

V Thirunavukarasu ,
T Carter ,
A Dezso  and
C Holland
V Thirunavukarasu*
Affiliation:
Department of ENT, Walsall Manor Hospital, Walsall, UK
T Carter
Affiliation:
Department of ENT, Walsall Manor Hospital, Walsall, UK
A Dezso
Affiliation:
Department of ENT, Walsall Manor Hospital, Walsall, UK
C Holland
Affiliation:
Department of Radiology, Walsall Manor Hospital, Walsall, UK
*
Address for correspondence: Mr Vijay Thirunavukarasu, 27 Vicarage Road, Edgbaston, Birmingham B15 3HB, UK E-mail: teeveeraj@yahoo.com
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Abstract

Objective:

We report a rare case of temporal bone metastasis from a lung primary, presenting only as post-aural tenderness.

Case report:

A 57-year-old man presented to our out-patient department with left post-aural pain of four months' duration. Clinical examination revealed tenderness in the left post-aural region; the ear, nose and throat examination was otherwise unremarkable. Computed tomography and contrast-enhanced magnetic resonance imaging showed erosion of the left petrous temporal bone. Incisional biopsy was carried out. Histopathological and immunohistochemical analysis showed infiltrative metastatic adenocarcinoma of the lung. Further imaging with positron emission tomography confirmed increased uptake from the right lower lobe of the lung, suggesting the site of the primary lesion. The patient was treated with chemo-radiotherapy.

Conclusion:

Post-aural pain is a non-specific symptom, and, with normal clinical and audiometric test results, rare lesions such as the one presented could be easily missed. A thorough clinical examination must be performed to identify genuine signs, and appropriate imaging undertaken to exclude rare causes, such as this metastatic lesion of the temporal bone.

Keywords

Neoplasm MetastasisTemporal BoneLung AdenocarcinomaOtalgia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 10 , October 2013 , pp. 1017 - 1019
Copyright
Copyright © JLO (1984) Limited 2013 

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