Malignant Degeneration of Squamous Papilloma Involving the Temporal Bone

We report a rare case of malignant degeneration of a squamous papilloma to squamous cell carcinoma. A 47-year-old female presented at our tertiary referral center with squamous papilloma of the middle ear that transformed into advanced-stage (T4N0M0) squamous cell carcinoma of the temporal bone, with involvement of the facial nerve, labyrinth, temporomandibular joint, sigmoid sinus, and dura of the middle and posterior cranial fossae. An extended subtotal temporal bone resection, selective neck dissection, and superficial parotidectomy were performed, followed by concurrent radiation therapy and chemotherapy. At 9 months post-surgery, a clinical exam and imaging suggested disease-free status. Although extremely rare, malignant transformation of a benign squamous papilloma of the temporal bone can occur. These lesions should be managed by gross total tumor resection, with judicious preservation of vital structures, followed by close tumor surveillance.