Mixed Adenoma and Well-Differentiated Neuroendocrine Tumor (MANET) of the Middle Ear

A 45-year-old male presented with acute mastoiditis and facial nerve paralysis.Computerized tomography of the temporal bone demonstrated complete opacification of left mastoid air cells, near complete middle ear cavity opacification, and bony erosion of the petrous apex extending to the left geniculate ganglion and proximal facial nerve canal.There was associated tympanic membrane thickening and external auditory canal debris.The patient was referred for mastoidectomy at which point a biopsy was performed.