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Ceruminous Adenoma of the External Auditory Canal: A Case Report with Imaging and Pathologic Findings.

Psillas G, Krommydas A, Karayannopoulou G, Chatzopoulos K, Kanitakis J, Markou K - Case Rep Med (2015)

Bottom Line: Immunohistochemistry confirmed the presence of two distinct cell populations.The luminal cells expressed keratin 7, while peripheral (basal) cells expressed keratins 5/6, S100 protein, and p63.The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells.

View Article: PubMed Central - PubMed

Affiliation: 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, 546 36 Thessaloniki, Greece.

ABSTRACT
Ceruminous adenomas are benign tumors that are rare in humans and present with a nonspecific symptomatology. The treatment of choice is surgical excision. We present an 87-year-old woman who presented with a reddish, tender, round, soft mass of the outer third of the inferior wall of the left external auditory canal, discharging a yellowish fluid upon pressure. Coincidentally, due to her poor general condition, this patient also showed symptoms consistent with chronic otitis media, parotitis, and cervical lymphadenopathy, such as otorrhea, through a ruptured tympanic membrane and swelling of the parotid gland and cervical lymph nodes. The external auditory canal lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. The pathological diagnosis was ceruminous gland adenoma. The tumor was made of tubular and cystic structures and embedded in a fibrous, focally hyalinized stroma. Immunohistochemistry confirmed the presence of two distinct cell populations. The luminal cells expressed keratin 7, while peripheral (basal) cells expressed keratins 5/6, S100 protein, and p63. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. The postoperative course was uneventful and at the 2-year follow-up no recurrence of the ceruminous adenoma was noted.

No MeSH data available.


Related in: MedlinePlus

CT imaging depicting otitis media of the left ear with external ear canal obstruction (∗) due to the cystic lesion.
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fig1: CT imaging depicting otitis media of the left ear with external ear canal obstruction (∗) due to the cystic lesion.

Mentions: Physical examination revealed a reddish, round, tender soft mass of the outer third of the inferior wall of the left EAC, discharging a yellowish fluid upon pressure; however, a concomitant ruptured tympanic membrane and otorrhea through this perforation were also found. No cranial nerve palsy was detected. Swelling of the left parotid region and bilateral cervical lymphadenopathy were also present. CT scan of the temporal bone showed a cystic lesion on the inferior cartilaginous part of the EAC but no temporal bone lysis; the middle ear appeared to contain fluid and swelling of the parotid gland and cervical lymph nodes bilaterally were also seen (Figure 1). The audiogram revealed conductive hearing loss of the left ear. The patient was treated with intravenous cefuroxime. A specimen of the discharge was sent for bacteriological evaluation and turned out to be negative for bacteria.


Ceruminous Adenoma of the External Auditory Canal: A Case Report with Imaging and Pathologic Findings.

Psillas G, Krommydas A, Karayannopoulou G, Chatzopoulos K, Kanitakis J, Markou K - Case Rep Med (2015)

CT imaging depicting otitis media of the left ear with external ear canal obstruction (∗) due to the cystic lesion.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663314&req=5

fig1: CT imaging depicting otitis media of the left ear with external ear canal obstruction (∗) due to the cystic lesion.
Mentions: Physical examination revealed a reddish, round, tender soft mass of the outer third of the inferior wall of the left EAC, discharging a yellowish fluid upon pressure; however, a concomitant ruptured tympanic membrane and otorrhea through this perforation were also found. No cranial nerve palsy was detected. Swelling of the left parotid region and bilateral cervical lymphadenopathy were also present. CT scan of the temporal bone showed a cystic lesion on the inferior cartilaginous part of the EAC but no temporal bone lysis; the middle ear appeared to contain fluid and swelling of the parotid gland and cervical lymph nodes bilaterally were also seen (Figure 1). The audiogram revealed conductive hearing loss of the left ear. The patient was treated with intravenous cefuroxime. A specimen of the discharge was sent for bacteriological evaluation and turned out to be negative for bacteria.

Bottom Line: Immunohistochemistry confirmed the presence of two distinct cell populations.The luminal cells expressed keratin 7, while peripheral (basal) cells expressed keratins 5/6, S100 protein, and p63.The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells.

View Article: PubMed Central - PubMed

Affiliation: 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, 546 36 Thessaloniki, Greece.

ABSTRACT
Ceruminous adenomas are benign tumors that are rare in humans and present with a nonspecific symptomatology. The treatment of choice is surgical excision. We present an 87-year-old woman who presented with a reddish, tender, round, soft mass of the outer third of the inferior wall of the left external auditory canal, discharging a yellowish fluid upon pressure. Coincidentally, due to her poor general condition, this patient also showed symptoms consistent with chronic otitis media, parotitis, and cervical lymphadenopathy, such as otorrhea, through a ruptured tympanic membrane and swelling of the parotid gland and cervical lymph nodes. The external auditory canal lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. The pathological diagnosis was ceruminous gland adenoma. The tumor was made of tubular and cystic structures and embedded in a fibrous, focally hyalinized stroma. Immunohistochemistry confirmed the presence of two distinct cell populations. The luminal cells expressed keratin 7, while peripheral (basal) cells expressed keratins 5/6, S100 protein, and p63. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. The postoperative course was uneventful and at the 2-year follow-up no recurrence of the ceruminous adenoma was noted.

No MeSH data available.


Related in: MedlinePlus