Diagnosis and Management of Middle Ear Neuroendocrine Tumour (MeNET)

Middle ear neuroendocrine tumours (MeNETs) are rare epithelial neoplasms with neuroendocrine differentiation that pose significant diagnostic and therapeutic challenges. The clinical presentation of MeNETs is often nonspecific and can mimic other middle ear pathologies, such as chronic otitis media, cholesteatoma, or paraganglioma Common symptoms include conductive hearing loss, otalgia, intermittent or persistent tinnitus, ear fullness, and dizziness. We present five patients who underwent surgery in our University Otolaryngology Centre between 2019 and 2025, in whom histopathological examination confirmed the diagnosis of MeNET. Although MeNET is typically considered an indolent tumour, rare cases of locally aggressive behaviour and distant metastases have been reported in the literature. Metastatic potential appears to correlate with histopathological features such as increased mitotic activity, Ki-67 proliferation index > 5%. The treatment of choice for MeNET is surgical resection of the tumour, with the choice of surgical technique depending on the stage of the tumour, its relationship to surrounding anatomical structures, and the possibility of hearing preservation. In our study, we highlighted the importance of radical tumour excision to minimize the risk of recurrence. Given the risk of recurrence and the risk of potential metastases, long-term follow-up is necessary, particularly in patients with advanced-stage tumours.