A hairy polyp presenting as a middle ear mass in a pediatric patient

Abstract

Middle ear masses in the pediatric population are rare. They may present with conductive hearing loss or recurrent otitis media.lM4 The most common middle ear mass in the pediatric age group is cholesteatoma, either congenital or acquired. Other more rare congenital pediatric middle-ear masses include hamartomas, choristomas, and teratomas. Hamartomas are growths of mature tissues normally found in the anatomic site but abnormally arranged. Conversely, choristomas consist of normally arranged mature tissues not normally found in the anatomic site. A teratoma consists of mature or immature tissue types, which typically include all three germinal layers, ectoderm, mesoderm, and endoderm. Hamartomas and choristomas are always benign, whereas teratomas may be either benign or malignant. Benign teratomas may be further subdivided into epidermoid, dermoid, hairy polyp, and true teratoma categories, depending on the presence or absence of each of the three germinal layers and their adenexa.5 Therefore, epidermoid teratomas are ectodermal cysts without adenexal structures. Dermoid teratomas are ectodermal cysts with adenexal structures.2,5z6 Hairy polyp teratomas include both ectodermal and mesodermal tissues with adenexa.4,5*7p8 Complete teratomas are masses that contain all three germinal