Mentions: Sixty seven-year-old ex-tobacco user patient presented with a deep excavating ulcer in the left preauricular area with ear discharge, pain and facial nerve palsy [Figure 1a]. Computed tomography scan showed 4.3 cm × 3.3 cm hypodense soft tissue mass extending from preauricular soft tissue into the left external ear and middle ear causing destruction of ear ossicles (cT4N0M0). The biopsy showed a poorly differentiated adenocarcinoma. In view of extensive soft tissue involvement, ulceration and proximity to the internal carotid artery, the patient was not a candidate for surgery or radiotherapy. The Patient did not wish to receive intravenous chemotherapy, hence was started on oral metronomic chemotherapy with methotrexate 15 mg/m2 weekly and celecoxib 200 mg twice daily. Figure 1b shows the response to treatment after 03 months of therapy. Patient is currently continuation of same treatment and to his last follows up of more than 16 months his disease controlled clinically in the form of ulcer completely resolved and now there is no pain and discharge from the ear.
Affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
No MeSH data available.