A rare finding of pulmonary nodules in a middle ear neuroendocrine tumor: a case report and review of the literature

Neuroendocrine tumors (NETs) are usually found in the gastrointestinal tract and pancreas; however, they are rare in the middle ear. The presentation of vague symptoms, such as tinnitus and conductive hearing loss, complicates the diagnosis. We present a 46-year-old male with a history of right ear discharge and a previous canal wall-down mastoidectomy, suspected to have cholesteatoma recurrence. Imaging and surgery demonstrated a well-differentiated G1 NET in the middle ear. Postoperative metastatic workup revealed few pulmonary nodules needing ongoing observation. Middle-ear NETs are difficult to diagnose due to their rarity. This case underscores the importance of histological and immunohistochemical evaluation and the need for systemic assessment to rule out metastasis due to pulmonary nodules. We contribute to the limited literature highlighting the need to include NETs in the differential of middle ear masses and the usefulness of interdisciplinary teamwork.