Introduction:
Malignant tumors of the outer ear canal are quite seldom. An adenocarcinoma is a about 2.5% of all external ear neoplasms. We report a 71yo patient who has been admitted in our department with otorrhea left. A large polyp structure with suppurative fluid in the left outer ear canal could be seen. In pure tone audiogram a conductive hearing loss could be detected. Digital volume tomography (DVT) showed soft tissue in the left outer ear canal and epitympanon. After local antibiotic treatment the polyp has been removed from the dorsal wall of the outer ear canal as first step of surgical treatment. The tympanic membrane remained intact. Histology revealed an adenocarcinoma, however a metastasis could not be proved or disproved. We performed a detailed obseravtion of the whole body in order to find a primary tumor but no pathological findings could be detected. To reach an oncological clean situation we performed an radical ear surgery with creating an open mastoid cavity including partial removement of the auditory ossicles. Reconstruction of the auditory ossicles was made with a PORP. Histology of the second operation revealed no malignant structures. In the interdisciplinary tumor conference the formula pT1 cN0 cM0 R0 G2 – 3 L0 V0 has been set and a consecutive radiotherapy was suggested. The patient refused the treatment and is under clinical control.
Conclusion:
An adenocarcinoma of the outer ear canal is a rarity. In the last 30 years, only 17 cases have been registered in the cancer registry of Washington. The diagnostics of finding a primary tumor and possible metastasis is standard procedure as well as creating an oncological clean situation. Consecutive therapy following surgery should be defined in an interdisciplinary conference.
