Pleomorphic adenoma presenting with conductive hearing loss in the ear canal: a case report and review of the literature

Abstract

IntroductionPleomorphic adenoma accounts for 65 percent of all salivary gland tumors. It has been identified in several anatomical regions, but pleomorphic adenoma arising in the ear canal, first described in 1951, is extremely rare.Case presentationA 40-year-old Japanese man’s left ear canal was obstructed by a pleomorphic adenoma that caused mild conductive hearing loss. The tumor was resected and he remains disease-free two years after surgery.ConclusionsPleomorphic adenoma usually arises from a major and minor salivary gland, but pleomorphic adenoma of the ear canal is derived from the ceruminous gland. We discuss the present case and 37 other case reports in our effort to clarify the clinical features and the course of pleomorphic adenoma in the ear canal.

Retroauricular Pleomorphic Adenoma Arising from Heterotopic Salivary Gland Tissue

“…PAs originating in the external auditory canal are uniquely derived from ceruminous glands, the modified apocrine sweat gland of the ear canal. 6 Their histologic presentation is similar to that of PAs originating from salivary tissue as all are believed to be of myoepithelial origin. 6 …”

“… 6 Their histologic presentation is similar to that of PAs originating from salivary tissue as all are believed to be of myoepithelial origin. 6 …”

Pleomorphic Adenoma of the External Auditory Canal: A Rare Presentation

“…Primary tumors of the external auditory meatus are very rare; they grow slowly and affect both sexes equally with median age of 50 years [ 12 ]. Five percent of these tumors are ceruminous (modified sweat) gland tumors [ 3 ]. Benign ceruminous gland tumors include adenoma, chondroid syringoma (pleomorphic adenoma), and syringocystadenoma papilliferum, while malignant ceruminous gland tumors include adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma [ 10 , 13 ].…”

“…It is a slowly growing tumor [ 2 ], lobular, not well encapsulated, and with recurrence rate of 1–5% after appropriate excision [ 1 ]. PA of the external auditory canal (EAC) is extremely rare and belongs to a group of benign and malignant tumors of the EAC, derived from the ceruminous glands [ 3 ]. Approximately 5% of all external ear neoplasms are benign adenomas [ 4 ].…”

Obstruction of the external auditory meatus secondary to a giant pyogenic granuloma

“…Other lesions involving the EAC have been reported as potential causes of conductive hearing loss, including traumatic lesions,9 adenoid cystic carcinoma,3 pleomorphic adenoma of the ear canal derived from the ceruminous gland, which caused mild conductive hearing loss,10 and facial nerve schwannomas presenting as occlusive masses of the EAC 11. This case is unique as it is the first time a pyogenic granuloma of the EAC has been reported as leading to total obstruction of the EAC opening and resultant conductive hearing loss.…”