Chondromyxoid fibroma of the temporal bone: case report and review of the literature

OBJECTIVES: We describe the clinical presentation, imaging, and pathology results of a patient with chondromyxoid fibroma (CMF) involving the mastoid portion of the temporal bone. The literature covering CMF of the head and neck is reviewed. METHODS: The patient chart, including imaging and pathology results, was analyzed. An English-language literature review of skull base CMF was performed. RESULTS: Eighty-seven cases of CMF involving the head and neck have been reported in the scientific literature. Sixty-two cases involved the skull base, temporal bone, nasal cavity, or paranasal sinuses. Including this patient, only 8 cases of CMF isolated to the temporal bone have been reported. Most patients experience insidious onset of symptoms such as hearing loss or headache. A computed tomographic scan best shows the relationship of the tumor to surrounding bone and may show intratumoral calcification. Surgical removal was the treatment most commonly used. Although irradiation has been used in selected cases, it is usually avoided because of the potential risk for malignant transformation. CONCLUSIONS: Chondromyxoid fibroma, a slow-growing bone tumor, is exceedingly rare within the mastoid. Its differential diagnosis includes chordoma, chondroid chordoma, and low-grade myxoid chondrosarcoma. Surgical excision is the treatment of choice.