Yeungnam Univ J Med.  2018 Dec;35(2):244-247. 10.12701/yujm.2018.35.2.244.

Spontaneous migration of a congenital intratympanic membrane cholesteatoma

• Kim TH
• Lee KY
• Jung DJ

• KMID: 2433748
• DOI: http://doi.org/10.12701/yujm.2018.35.2.244

Abstract

Congenital intratympanic membrane cholesteatoma (ITMC) is a rare type of congenital cholesteatoma located within the tympanic membrane. This lesion tends to increase in size over time. The development of ITMC can cause several complications such as hearing impairment, dizziness, facial palsy, and intracranial complications, similar to any other cholesteatoma. The treatment of congenital cholesteatoma requires the removal of the lesion through surgery, because disease progression induces bony destruction of the nearby tissue. Most patients presenting with this cholesteatoma type are also treated with primary surgical removal. However, we recently experienced a case of an ITMC that showed a natural transition to an external auditory canal cholesteatoma.

Keyword

Congenital cholesteatoma; External auditory canal; Tympanic membrane

MeSH Terms

Cholesteatoma*
Disease Progression
Dizziness
Ear Canal
Facial Paralysis
Hearing Loss
Humans
Membranes*
Tympanic Membrane

Figure

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  Fig. 1. Otoscopic finding. A pearly white mass is located at the end of handle of the left malleus, in the center of the left tympanic membrane.

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  Fig. 2. Tympanograms. Tympanometry showed type A pattern in both ears.

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  Fig. 3. Temporal computed tomography (CT). (A) Axial non-enhanced CT shows a soft tissue density of a round mass between the left tympanic membrane and the handle of the left malleus (arrow). (B) The soft tissue density is located at the lateral side of the handle of the left malleus (arrow).

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  Fig. 4. Otoscopic finding after 2 months. The mass initially presumed to be an intratympanic membrane congenital cholesteatoma had moved laterally and became an external auditory canal mass.

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  Fig. 5. Microscopic finding shows stratified squamous epithelium (arrow) and keratin debris (arrowhead) (H&E stain, ×200).

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