The authors would like to present a rare case of the middle ear cancer which has been developed in postoperative cave in 67 years old patient operated for cholesteatoma 50 years earlier. The patient was admitted to the ENT Department of Poznań University of Medical Sciences because of the ear suppuration and headache occurring for 3 months. CT and MR images suggested granulation tissue fi lling the postoperative spaces with bone destruction, infi ltration of the dura and temporal lobe abscess formation. Intraoperative fi ndings allowed excluding the preliminary diagnosis of intracranial complication in the course of chronic otitis media, revealing the tissue masses resembling neoplastic infi ltration. The histopathology examination confi rmed the fi nal diagnosis of squamous cell cancer. The patient was directed to radiotherapy. The authors report a case of middle ear squamous cell carcinoma and discuss its diagnostic aspect.