A brief survey of the literature reveals that mastoiditis without preceding otitis media is no longer a rare condition, especially since the introduction of modern chemotherapy. According to Hempstead,' Dabrey in 1915 found in the literature reports of 24 cases. By 1929 the number of reported cases had increased to 146. By now the number of cases are so numerous that such reviews are unnecessary. Most of the instances seen nowadays represent a late flare-up following the cessation of chemotherapy. Hanse12 has given a thorough discussion of the pathogenesis of this condition. This report, therefore, is limited to a case in point and to a discussion of those aspects which may help in making an early diagnosis.