Detection of Epstein-Barr and Human Papilloma Viruses in the Middle Ear Squamous Cell Carcinoma

  • Agus Surono
  • Bambang Hariwiyanto
  • Edhie Samodra
Original Article


The uncommon ear tumor of middle ear squamous cell carcinoma (MESCC) is thought to be associated with the history of long-term chronic otitis media in the most cases. The main etiologic factor of MESCC is still unclear and may be multifactorial. Infections of Epstein-Barr virus (EBV) and Human Papillomavirus (HPV) are considered as one of the etiologic factor of MESCC. Previous studies have shown that the EBV and HPV have been detected in MESCC. Although the EBV and HPV have been implicated in human malignancies, their roles in pathogenesis of MESCC have not been elucidated. There has never been report on the presence of EBV and HPV in Indonesian MESCC. This study aimed to determine the presence of EBV and HPV in MESCC. Seven paraffin-embedded tissues of speciment from biopsy were analyzed for the presence of EBV and HPV by immunohistochemistry, stained using polyclonal antibody anti EBNA1 and anti HPV. The samples consisted of 4 (57 %) males and 3 (43 %) females with age range of 26–87 years old. Immunohistochemistry result demonstrated that EBV was detected in three of seven (43 %) and HPV in two of seven (29 %) samples. Coexistence of the presence of EBV and HPV were found in one of seven (14 %) sample. The presence of EBV and HPV in MESCC suggests that viral infection may play an important etiologic role in the carcinogenesis of middle ear.


Middle ear squamous cell carcinoma EBV HPV Immunohistochemistry 



The authors would thank to Hariyadi MD for confirming the immunohisto-chemistry results, Arif Budiyanto MD for revising the manuscript, Mrs Agustin for preparing materials and laboratory work, and Ms Yuni as the data manager in Oncology division, Department of Otolaryngology Head and Neck Surgery Faculty of Medicine UGM. This study was supported by Dana Masyarakat FK UGM.


This work was supported by grant of Dana Masyarakat A21/2012 (Dr. Surono) from Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Complaisance with Ethical Standards

Conflict of interest

The authors confirm that they have no potential conflicts of interests that could inappropriately influence or bias this work.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Association of Otolaryngologists of India 2016

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of MedicineUniversitas Gadjah MadaYogyakartaIndonesia

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