Unusual mass in the external auditory canal of an adult man

Abstract

Our case report describes a man in his 6th decade of life who presented for difficulty hearing out of his left ear for the past three years, predominantly in loud settings. The patient denied vertigo, facial weakness, pain, blood, or drainage out of either ear. His past medical history was significant for hypertension and hyperlipidemia. Physical examination revealed a normal appearing left pinna and a soft erythematous cyst in the left external auditory canal (EAC) obscuring the left tympanic membrane (TM). The right ear, pinna, EAC, and TM all appeared normal. An audiogram of both ears showed conductive hearing loss on the left. CT scan of the left temporal bone showed a lobular lesion with a central hyperdensity arising from the anterior wall of the left EAC and extending into the EAC. Surgical excision of the mass revealed a large cyst originating in the superior ear canal and extending towards the TM. A second cyst was found and excised along the central part of the TM. Immunohistochemical staining of both cysts confirmed a paraganglioma of the EAC. The purpose of our report is to highlight a case of a rare site for a head and neck paraganglioma arising in the external auditory canal and causing hearing loss. We aimed to clarify the characteristics of glomus cell neoplasms to enable physicians to make a clinical diagnosis and initiate appropriate treatment.