Destruction of the temporal bone pyramid - differential diagnosis towards recurrence of lateral pharyngeal cancer or an intra-temporal otogenic complication?

Squamous cell carcinoma (SCC) is the most prevalent malignant tumour of head and neck region. It can develop through metaplasis of squamous epithelium of mucosa or skin. Regarding broad spectrum of vague symptoms initially, the disease is often diagnosed in advanced stadium. Surgical resection with adjuvant chemo-and radiotherapy is mainstay of treatment in locally advanced carcinoma. Despite radical and successful treatment of primary lesion, cancer recurrences are common. Similarities between signs and symptoms of cancer recurrences and post-treatment side-effects pose a significant challenge in long-term follow-up management. We present a case report of 66-years-old patient, in whom there was serious doubts in differentiating between SCC recurrence and an intratemporal otitis media complication manifestating as facial nerve palsy.