Though squamous cell carcinoma is the commonest tumor, it rarely presents in the middle ear andfollows a history of chronic ear discharge. Postauricular mastoid fistula is also a rare complicationof chronic otitis media. These two pathological changes occurring simultaneously are even rarer.We report a rare case of a 37 years old male with a history of left-sided chronic ear discharge andconductive hearing loss. Squamous cell carcinoma along with postauricular mastoid fistula wasdiagnosed based on high-resolution computed tomography scan and histopathology. Left modifiedradical mastoidectomy with tympanic membrane grafting was done under general anesthesia.Often middle ear tumor is associated with long-standing ear discharge and this case is a very goodexample. The co-occurrence of the middle ear tumor with mastoid fistula is extremely rare as boththe entities are rare in itself.
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