Middle-ear carcinoma is very rare, and primary radical surgery followed by adjuvant radiotherapy is held to give better survival than radical radiotherapy alone. If resection produces no cure, chemoradiation may be attempted but curability using conventional external irradiation is low. A 56-year-old woman with unresectable advanced middle-ear carcinoma was found in computed tomography to have irregularly enhanced soft tissue filling the right external auditory canal, middle ear cavity, and mastoid, and diffusely destroyed temporal bone. The tumor had destroyed the carotid artery bone canal. Enhanced magnetic resonance imaging showed diffusely thickened posterior fossa dura mater. She was treated successfully with conventional external irradiation and subsequent stereotactic irradiation combined with chemotherapy. Stereotactic irradiation thus proved extremely effective against local residual and metastatic bone lesions.
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