Presumably, it is related to chronic inflammation. Squamous cell cancer of the middle ear is often quite advanced before a correct diagnosis is made. Pain is a significant feature of squamous cell cancer of the middle ear and mastoid. Intermittent hemorrhage, bleeding and drainage for long periods of time are also usual. Heaing loss is significant.
Diagnosis depends upon a biopsy of the tissue.
An examination by the ear surgeon investigating a perforated eardrum which shows suspicious tissue in the middle ear or mastoid that does not heal after appropriate medical therapy would indicate a need for a biopsy. Suspicion should be aroused about any unusual tissue which is seen through a perforated eardrum or mastoid, particularly those that are painful. CT scan and MRI are necessary in order to help determine the extent of surgery necessary. Squamous cell cancer of the middle ear and mastoid is a fatal disease, if not treated properly. Even with early surgery and radiation therapy, cure may not be possible if the tumor is deeply invasive.