Zeruminal pleomorphic adenoma ("mixed tumor") of the ear canal

New masses of the external auditory canal are commonly atheromas, fibroids or exostoses. Adenomas of the external auditory canal are rare. A pleomorphic adenoma in the ear canal is described as the most rare subgroup of tumors of the cerumen glands.

We report a 53-year-old patient who has suffered from hearing loss and a right ear sensation for nine months. Otorrhea or dizziness were denied. Ear microscopy revealed a mass on the posterior wall of the ear canal. The eardrum could not be evaluated. Through an endaural approach, the mass was completely removed. The defect coverage was performed with a full-thickness graft of the retroauricular area. The ear canal tamponade was removed after two weeks, it showed a intact eardrum and vital graft. Histopathology revealed an unencapsulated pseudo-infiltrating neoplasia consisting of an epithelial and a stromal component in different growth patterns ("mixed tumor"). The distinction between a highly differentiated carcinoma and an adenoma was uncertain, which is why a subsequent resection was indicated.

In the case of ear microscopy in everyday ENT practice, pleomorphic adenoma should be considered as a differential diagnostic for an unclear mass in the ear canal, despite the rarity. An exsizion biopsy is therefore indispensable as a first diagnostic measure in these cases. In case of unclear histopathological findings, follow-up resection should be performed.

Publication History

Publication Date:
18 April 2018 (online)