A Case of Middle-Ear Capillary Hemangioma

Abstract

We report a case of capillary hemangioma extending from the middle ear to the mastoid cell and external auditory meatus. A 59-year-old man with bloody left-ear otorrhea was found in otoscopic examination to have a dark red hemorrhagic mass filling in the left external auditory meatus. Biopsy of the mass showed capillary hemangioma. Temporal bone computed tomography (CT) showed dense soft-tissue from the middle ear to the mastoid cell and external auditory meatus. Gadolinium-enhanced magnetic resonance imaging (MRI) showed strong contrasting meatus and middle-ear enhancement. The tumor, which was removed in a transmastoid approach under general anesthesia, was shown pathologically to be pyogenic granuloma with outstanding inflammatory change with capillary hyperplasia. Pyogenic granuloma is usually secondary change from capillary hemangioma due to trauma, infection, etc. The clinical course and radiological examination suggested that middle-ear capillary hemangioma with the secondary change occurred as pyogenic granuloma progressed to the meatus. Pyogenic granuloma has been reported in Japan, but not capillary hemangiomas, which rarely occurs in the ear.