Adenoid cystic carcinoma of external auditory canal: A rare disease.

Abdul Basit Vardag Abdul Basit Vardag,Muhammad Hammad Muhammad Hammad,Muhammad Usman Tariq Muhammad Usman Tariq,Muhammad Hassan Danish Muhammad Hassan Danish,Muhammad Sohail Awan Muhammad Sohail Awan,Omaima Anis Bhatti Omaima Anis Bhatti

doi:10.47391/jpma.572

Abstract

External auditory canal, like other epithelialized surfaces is predisposed to malignancies such as Squamous cell carcinomas (SCC), melanomas and adenocarcinomas. In this background, malignancies like adenoid cystic carcinoma (ACC) are a rare occurrence and need to be thoroughly evaluated both locally and for distant extension. The malignancy needs to be addressed with an aggressive approach surgically with adequate marginal clearance. The role of radiation is debatable considering the outcomes in the limited data. Here we present the case of a 35-year-old female who came in with otalgia and otorrhea associated with a mass in the external auditory canal. After biopsy and imaging, a diagnosis of adenoid cystic carcinoma was made and the patient was managed accordingly.

Highlights

External ear malignancies are an oddity with squamous cell carcinoma (SCC)being the most commonly seen malignancy.[1]
We present the case of a 35-year-old female who came in with otalgia and otorrhea associated with a mass in the external auditory canal
ACC has an Figure-2: A) Coronal view showing enhancing lesion in right external auditory canal arising from superior canal. inclination towards the oral cavity and the B) Sagittal view showing soft tissue lesion partially obstructing the lumen of external auditory canal

Summary

Introduction

Being the most commonly seen malignancy.[1]. In this background, the incidence of adenoid cystic carcinoma (ACC) is worth mentioning. ACC has an Figure-2: A) Coronal view showing enhancing lesion in right external auditory canal arising from superior canal. On examination, her right ear was tender to touch and otoscopic examination revealed a firm and non-fluctuant swelling arising from the posterosuperior aspect of the EAC. The dermis and the subcutaneous adipose tissue were infiltrated by a neoplastic lesion composed of nodules and nests with frequent small cystic spaces and tubule formation (Figure-3A and B). These basaloid neoplastic cells had scant cytoplasm and round to oval uniform nuclei with fine chromatin, inconspicuous nucleoli and scattered mitotic figures. The patient was last seen in March 2020 at the clinic, she is disease free and doing well

Discussion

Findings

Conclusion