Histopathological Study and Registry of Tumors and Tumor-like Lesions of the Ear at Ain-Shams University Hospitals in years (2001-2010)

Abstract

The aim of this work was hospital based registration and histopathological study of all cases of tumors and tumor-like lesions of the ear received at the pathology department, Ain-Shams University Hospital and Ain-Shams University Specialized Hospital during a period of 10 years (2001-2010). Re-examination of all available haematoxylin and eosin stained and immunostained slides was performed to verify histopathological diagnosis. Statistical analysis of the clinicopathological data extracted from files and clinical parameters were also done. The cases of the study were registered as regards the histopathological diagnosis and available clinical data as well as age, sex, site and behavior collected from files of the patients. The results of this registry study revealed that tumors and tumor-like lesions of the ear diagnosed during the period from January 2001 to December 2010 at the pathology department of Ain Shams University Hospital and Ain Shams University Specialized Hospital were 85 cases. The highest percentage of referred cases was in year 2002 (17.6%) followed by 2003 (14.1%) and 2010 (11.8%). The male cases were 51 cases (60%), while the female cases were 34 cases (40%), with male to female ratio (3:2). The age of cases ranged from 14 to 84 years old. The mean age was 49.4 with standard deviation (SD) = 17.3 with no significant difference in the mean age between males and females, and the median age was 52 years. The most common site of tumors and tumor-like lesions of the ear was the external ear. Out of 85 cases, 54 cases (63.5 %) arose from the external ear and 30 cases (35.3 %) arose from the middle ear. A higher percentage of external ear lesions among males (78.4%) compared to (41.2%) among females, whereas, a higher percentage of middle ear lesions among females (58.8%) compared to (19.6%) among males and the difference was highly significant statistically (P<0.01). The majority of ear lesions arose from the skin and subcutaneous tissue (51.8 %) followed by lesions of neural or ganglion origin (28.3 %). The skin &SC tissue were the major origins of lesions among males (58.8 %) while lesions of neural or ganglion origin were higher among females (52.9 %) and the difference was highly significant statistically (P<0.01). Out of the 85 cases, tumors represented (91.8 %) of cases and tumor-like lesions were (8.2 %). A higher percentage of tumors was found among females (94.1%) compared to (90.2%) among males, while a higher percentage of tumor-like lesions was found among males (9.8%) compared to (5.9%) among females but the difference was not significant statistically (P>0.05). The most common histopathological type of lesion was paraganglioma (27.1 %) followed by squamous cell carcinoma (25.9 %) then twelve cases (14.1 %) were osteoma and seven cases (8.2%) were keratotic skin lesions. Only 2 cases (2.4 %) were basal cell carcinoma and 2 cases (2.4 %) were the so-called middle ear adenoma and carcinoid tumor. Only one case of metastasis from mucoepidermoid carcinoma of parotid. A higher percentage of squamous cell carcinoma was found among males (33.3%) compared to (14.7%) among females and higher percentage of osteoma was detected among males (21.6%) compared to (2.9%) among females. A higher percentage of paraganglioma among females (52.9%) compared to (9.8%) among males and the difference is highly significant statistically. A higher percentage of squamous cell carcinoma among older age group subjects, while there was a higher percentage of keratotic skin lesions among younger age group but the difference was not significant statistically(P<0.01). Only 32.9 % of all cases were malignant tumors. There was a higher percentage of malignant behavior among older age group patients >52 years (45%) compared to (22.2%) among younger age group ≤52 years and the difference was significant statistically (P<0.05). A higher percentage of malignant behavior was found among males compared to females but the difference was not significant statistically. In addition, cases were divided according to year of collection into group I including cases collected from 2001 to 2005 and group II including cases from 2006 to 2010. A higher percentage of malignant behavior among Group II compared to group I but the difference was not significant statistically (P>0.05). Malignant ear tumors of year group I (2001-2005) represented 0.16% of total malignant tumors diagnosed during the same period. Also, non-melanoma skin cancer diagnosed in the ear during year group I constituted 5.12 % of total non-melanoma skin cancer diagnosed during the same period.