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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

H/E ×100. Two cystic-tubular formations lined by columnar cells with an eosinophilic cytoplasm are seen.
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fig3: H/E ×100. Two cystic-tubular formations lined by columnar cells with an eosinophilic cytoplasm are seen.

Mentions: The EAC lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. Macroscopically the resection specimen was a fusiform skin sample measuring 1.9 × 1.5 × 1 cm. Upon sectioning a 1.4 cm cystic lesion was found in the subcutaneous tissue. Microscopic examination showed an epithelial cystic lesion whose wall contained two cell populations. The inner ones consisted of middle-sized cylindrical or cuboidal cells with an eosinophilic cytoplasm and round nuclei, arranged in tubules (Figure 2). The cylindrical cells occasionally showed cytoplasmic projections in the lumens of the tubules. The second cell population consisted of ovoid or spindle cells, with elongated nuclei, which were arranged in fascicles, small solid groups, and rare tubules. Neither atypia nor mitotic activity were observed. The tumor was embedded in a fibrous, focally hyalinized stroma; it was partly surrounded by a thin fibrous capsule and was not connected to the overlying epidermis. 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. Several cells, mainly luminal, showed membranous expression of CD117/c-kit. p53 and Ki-67 were expressed in about 60% and 5% of nuclei, respectively. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. Based on these histopathological and immunohistochemical findings the diagnosis of ceruminous gland adenoma was established (Figures 3–5).


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)

H/E ×100. Two cystic-tubular formations lined by columnar cells with an eosinophilic cytoplasm are seen.
© Copyright Policy
Related In: Results  -  Collection

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

fig3: H/E ×100. Two cystic-tubular formations lined by columnar cells with an eosinophilic cytoplasm are seen.
Mentions: The EAC lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. Macroscopically the resection specimen was a fusiform skin sample measuring 1.9 × 1.5 × 1 cm. Upon sectioning a 1.4 cm cystic lesion was found in the subcutaneous tissue. Microscopic examination showed an epithelial cystic lesion whose wall contained two cell populations. The inner ones consisted of middle-sized cylindrical or cuboidal cells with an eosinophilic cytoplasm and round nuclei, arranged in tubules (Figure 2). The cylindrical cells occasionally showed cytoplasmic projections in the lumens of the tubules. The second cell population consisted of ovoid or spindle cells, with elongated nuclei, which were arranged in fascicles, small solid groups, and rare tubules. Neither atypia nor mitotic activity were observed. The tumor was embedded in a fibrous, focally hyalinized stroma; it was partly surrounded by a thin fibrous capsule and was not connected to the overlying epidermis. 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. Several cells, mainly luminal, showed membranous expression of CD117/c-kit. p53 and Ki-67 were expressed in about 60% and 5% of nuclei, respectively. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. Based on these histopathological and immunohistochemical findings the diagnosis of ceruminous gland adenoma was established (Figures 3–5).

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