Medical imaging of malignant external otitis in the presence of squamous cell carcinoma

Necrotizing or malignant external otitis (MEO) also known as malignant otitis externa (MOE) is a severe invasive infection of the external auditory canal that invades the base of the skull and causes potentially life-threatening complications. MEO is often found in elderly patients with diabetes mellitus, chronic kidney disease (CKD) and kidney failure [1] [2] or other conditions that compromise the body’s immune system such as in cancer patients receiving chemotherapy and radiotherapy [3]. This case report is for an elderly deceased female patient with squamous cell carcinoma (SCC) and malignant external otitis of the left external auditory canal (EAC). The patient has a European ancestry and has lived all her life in the Kingdom of Saudi Arabia (KSA), together with her husband and their children. Although a good quality of life (QOL) was always maintained for the patient, she suffered difficult health conditions from time to time throughout her life. In this case study, a detailed report of the patient’s case is presented including her family ancestry genetic testing results in addition to a number of medical images (and analysis) via computed tomography (CT) scan and magnetic resonance imaging (MRI). It was found that the patient’s paternal ancestry is positive to the human Y-DNA haplogroup R-M198, which is found at its highest frequencies in the Central and Eastern Europe, essential to understand the causes related to the health conditions of this patient. Furthermore, the medical images from the CT scan and Brain MRI revealed detailed information of the patient’s case of MEO and SCC. CT scan revealed osteomyelitis (and extension of infection) of the temporal bone, whereas MRI was superior to CT in estimating the anatomic extent including inflammation of fat, connective tissue, muscles, bone, and cartilage.