Cholesteatoma morphed into temporal bone squamous cell carcinoma

Abstract Cholesteatoma and the ensuing chronic inflammation may promote temporal bone tumorigenesis. Our patient is an 80-year-old female who had undergone left ear surgery 72 years prior. She presented with a 3-month history of left facial asymmetry associated with otalgia. Patient had been having intermittent discharge from the left ear since her first ear surgery but worsened in the recent 3 months. The patient underwent mastoid exploration. Histopathological study showed no evidence of dysplasia or malignancy. At one-year post surgery, the patient was noted to have soft tissue swelling in the mastoid region which was reported as squamous cell carcinoma. Scans showed extensive disease with possible extradural involvement. Therefore, she was given radical radiotherapy. Chronic ear infection, especially cholesteatoma, may progress to temporal bone malignancy. If the tumour is advanced or the patient’s condition is unfavourable for the surgery, radiotherapy can be a useful modality of treatment.